Provider Demographics
NPI:1437409976
Name:GRUPO MEDICO CARDIOVASCULAR-PY
Entity type:Organization
Organization Name:GRUPO MEDICO CARDIOVASCULAR-PY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YANISLEY
Authorized Official - Middle Name:CRESPO
Authorized Official - Last Name:LAHERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-565-8179
Mailing Address - Street 1:URB. EL COMANDANTE C/ ANTONIO LUCIANO 1238
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00924
Mailing Address - Country:UM
Mailing Address - Phone:787-565-8179
Mailing Address - Fax:
Practice Address - Street 1:GK29 AVE ROBERTO SANCHEZ VILELLA
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-2657
Practice Address - Country:US
Practice Address - Phone:787-565-8179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty