Basic Information
| Provider Information | |||||||||
| NPI: | 1285800342 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WEST CARDIO GENERAL ANESTHESIA CSP | ||||||||
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| OtherOrganizationName: | WEST CARDIO GENERAL ANESTHESIA CSP | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 374 | ||||||||
| Address2: | |||||||||
| City: | CABO ROJO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006230374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7879754993 | ||||||||
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| Practice Location | |||||||||
| Address1: | CARR 2 | ||||||||
| Address2: | CENTRO MEDICO DE MAYAGUEZ | ||||||||
| City: | MAYAGUEZ | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006826353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7879754993 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2008 | ||||||||
| LastUpdateDate: | 06/03/2014 | ||||||||
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| AuthorizedOfficialLastName: | SANTA | ||||||||
| AuthorizedOfficialFirstName: | EILEEN | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7873603244 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.