Provider Demographics
NPI:1760226039
Name:ADVANCED CARDIOLOGY AND GERIATRIC CARE OF PUERTO RICO
Entity type:Organization
Organization Name:ADVANCED CARDIOLOGY AND GERIATRIC CARE OF PUERTO RICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:B
Authorized Official - Last Name:HERNANDEZ GIL DE LAMADRID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-223-5442
Mailing Address - Street 1:PO BOX 1601
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-1601
Mailing Address - Country:US
Mailing Address - Phone:787-223-5442
Mailing Address - Fax:787-421-7075
Practice Address - Street 1:10 AVE LAS CUMBRES
Practice Address - Street 2:PROFESSIONAL MEDICAL PLAZA 306
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-223-5442
Practice Address - Fax:787-421-7075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-21
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty