Provider Demographics
NPI:1770772337
Name:LABORATORIO CARDIOSVASCULAR ACUARELA PSC
Entity type:Organization
Organization Name:LABORATORIO CARDIOSVASCULAR ACUARELA PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-272-6146
Mailing Address - Street 1:MARGINAL ACUARELA C-9
Mailing Address - Street 2:HIGHLAND GARDENS
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-272-6146
Mailing Address - Fax:787-287-1835
Practice Address - Street 1:MARGINAL ACUARELA C-9
Practice Address - Street 2:HIGHLAND GARDENS
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-272-6146
Practice Address - Fax:787-287-1835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8470174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR82287OtherTRIPLE-S
PR500566EOtherMEDICARE Y MUCHO MAS
PR066635OtherLA CRUZ AZUL
PR82287Medicare PIN