Provider Demographics
NPI:1205929791
Name:CARDIOMAX CORP
Entity type:Organization
Organization Name:CARDIOMAX CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:MADRINAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-648-0127
Mailing Address - Street 1:1357 AVE ASHFORD # 281
Mailing Address - Street 2:
Mailing Address - City:CONDADO
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1400
Mailing Address - Country:US
Mailing Address - Phone:787-648-0127
Mailing Address - Fax:787-653-6089
Practice Address - Street 1:CDT PLAZA DE SALUD SANOS OFICINA 101 103
Practice Address - Street 2:AVENIDA RAFAEL CORDERO CALLE TROCHE
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-648-0127
Practice Address - Fax:787-653-6089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0084975174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR84975Medicare PIN