Provider Demographics
NPI:1720618929
Name:CVO INTERNISTA LLC
Entity Type:Organization
Organization Name:CVO INTERNISTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:E
Authorized Official - Last Name:VALE COLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-877-1990
Mailing Address - Street 1:PO BOX 1858
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1858
Mailing Address - Country:US
Mailing Address - Phone:787-877-1990
Mailing Address - Fax:
Practice Address - Street 1:EDIF VALE COLON OFIC 6 CARR 111 KM 3.5
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-0067
Practice Address - Country:US
Practice Address - Phone:787-877-1990
Practice Address - Fax:787-818-5973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty