Provider Demographics
NPI:1669405304
Name:HEALTHY HEART CARDIOVASCULAR CENTER PSC
Entity type:Organization
Organization Name:HEALTHY HEART CARDIOVASCULAR CENTER PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:UFRET-PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-961-0444
Mailing Address - Street 1:PO BOX 8937
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-8937
Mailing Address - Country:US
Mailing Address - Phone:787-961-0444
Mailing Address - Fax:
Practice Address - Street 1:AVEINDA MUNOZ MARIN
Practice Address - Street 2:HIMA PLAZA I STE 307
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-961-0444
Practice Address - Fax:877-283-7633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9166174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0085153Medicare PIN