Provider Demographics
NPI:1952701906
Name:CENTRO CARDIOVASCULAR DE ARECIBO, PSC
Entity Type:Organization
Organization Name:CENTRO CARDIOVASCULAR DE ARECIBO, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:SALGADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-879-4632
Mailing Address - Street 1:PO BOX 560
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-0560
Mailing Address - Country:US
Mailing Address - Phone:787-879-4632
Mailing Address - Fax:787-881-5762
Practice Address - Street 1:702 AVE SAN LUIS
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-3810
Practice Address - Country:US
Practice Address - Phone:787-879-4632
Practice Address - Fax:787-881-5762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRDM05598261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR207R10011XOtherINTERNAL MEDICINE
PR6407OtherINTERVENTIONAL CARDIOLOGY
PR207RC0000XOtherCARDIOVASCULAR DISEASE
PR207RC0000XOtherCARDIOVASCULAR DISEASE
PR207RC0000XOtherCARDIOVASCULAR DISEASE
PR207R10011XOtherINTERNAL MEDICINE