Organization Active NPI

Cardiovascular Surgery of PR PSC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • San Juan, PR
National Provider Identifier
1235458290
Registry record updated Mar 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
8880 Issued in PR
Legal business name
CARDIOVASCULAR SURGERY OF PR PSC
Practice address
735 Ave Ponce de Leon Suite 210
Torre Medica Auxilio Mutuo
San Juan, PR 00917-5024
Phone
(787) 773-0417
NPI assigned
May 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Juan J Hernandez, MD
Title
Doctor
Phone
(787) 773-0417

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X 8880 PR
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X 8880 PR Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X 16635 PR

Addresses

Primary practice location

735 Ave Ponce de Leon Suite 210
Torre Medica Auxilio Mutuo
San Juan, PR 00917-5024

Mailing address

735 Ave Ponce de Leon Suite 210
Torre Medica Auxilio Mutuo
San Juan, PR 00917-5024
Phone (787) 773-0417

National Provider Directory

National Provider Directory

Locations

735 Ave Ponce de Leon
Ste 210
San Juan, PR 00917
Phone (787) 305-0125

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331856000000",
    "number": "1235458290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON SUITE 210",
            "address_2": "TORRE MEDICA AUXILIO MUTUO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175024",
            "telephone_number": "787-773-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON SUITE 210",
            "address_2": "TORRE MEDICA AUXILIO MUTUO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175024",
            "telephone_number": "787-773-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR SURGERY OF PR PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-28",
        "last_updated": "2012-03-16",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "787-773-0417",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "PR",
            "license": "8880",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PR",
            "license": "8880",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PR",
            "license": "16635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.