Provider Demographics
NPI:1932454204
Name:INSTITUTO REGIONAL DEL CORAZON
Entity Type:Organization
Organization Name:INSTITUTO REGIONAL DEL CORAZON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DOMINGO
Authorized Official - Middle Name:
Authorized Official - Last Name:JEREZ JAVIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:809-246-1806
Mailing Address - Street 1:AVENIDA INDEPENDENCIA # 2
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO DE MACORIS
Mailing Address - State:SAN PEDRO DE MACORIS
Mailing Address - Zip Code:21000
Mailing Address - Country:DO
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA INDEPENDENCIA # 2
Practice Address - Street 2:
Practice Address - City:SAN PEDRO DE MACORIS
Practice Address - State:SAN PEDRO DE MACORIS
Practice Address - Zip Code:21000
Practice Address - Country:DO
Practice Address - Phone:809-246-1806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital