Provider Demographics
NPI:1730599739
Name:CARDIOVASCULAR SCIENCE SOLUTIONS GROUP LLC
Entity type:Organization
Organization Name:CARDIOVASCULAR SCIENCE SOLUTIONS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARRO-PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-844-2710
Mailing Address - Street 1:PO BOX 331788
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00733-1788
Mailing Address - Country:US
Mailing Address - Phone:787-844-2710
Mailing Address - Fax:
Practice Address - Street 1:2225 PONCE BYP STE 905
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1381
Practice Address - Country:US
Practice Address - Phone:787-844-2710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6958207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6958OtherLICENSE