Provider Demographics
NPI:1174623953
Name:LABORATORIO CARDIOVASCULAR DR. HECTOR COLOMBANY
Entity type:Organization
Organization Name:LABORATORIO CARDIOVASCULAR DR. HECTOR COLOMBANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:COLOMBANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-877-2121
Mailing Address - Street 1:URB JARDINES DE BORINQUEN CALLE 1 D14
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00602
Mailing Address - Country:US
Mailing Address - Phone:787-877-2121
Mailing Address - Fax:787-877-2145
Practice Address - Street 1:CARR 111KM 2.5
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-877-2121
Practice Address - Fax:787-877-2145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12303207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4859OtherINTERNATIONAL MEDICAL CAR