Provider Demographics
NPI:1952498834
Name:NORTHWEST CARDIOVASCULAR CARE
Entity Type:Organization
Organization Name:NORTHWEST CARDIOVASCULAR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICO
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:COLOMBANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-877-2121
Mailing Address - Street 1:CARR 111 KM 2.5 BO PALMAR
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:787-877-2121
Mailing Address - Fax:787-877-2145
Practice Address - Street 1:CARR 111 KM 2.5 BO PALMAR
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-877-2121
Practice Address - Fax:787-877-2145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12303207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR601031OtherMEDICARE Y MUCHO MAS