Provider Demographics
NPI:1053582866
Name:CARDIO VIEW AND VASCULAR CENTER CSP
Entity type:Organization
Organization Name:CARDIO VIEW AND VASCULAR CENTER CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-491-5050
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-0384
Mailing Address - Country:US
Mailing Address - Phone:787-491-5062
Mailing Address - Fax:787-737-4566
Practice Address - Street 1:CALLE 189 KM 7.8
Practice Address - Street 2:MAMEY I
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-0778
Practice Address - Country:US
Practice Address - Phone:787-491-5062
Practice Address - Fax:787-737-4566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13402207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH81136Medicare UPIN