Organization Active NPI

Instituto Cardiovascular de Coamo, CSP

  • Cardiovascular Disease Physician
  • Coamo, PR
National Provider Identifier
1679964373
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
12894 Issued in PR
Legal business name
INSTITUTO CARDIOVASCULAR DE COAMO, CSP
Practice address
134 Calle Jose I Quinton
Coamo, PR 00769
Phone
(787) 803-3636
Fax
(787) 803-3637
NPI assigned
Feb 17, 2015
Last updated
Oct 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Authorized official

Name
Henry Diaz Diaz, MD
Title
President
Phone
(787) 803-3636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 12894 PR Primary

Addresses

Primary practice location

134 Calle Jose I Quinton
Coamo, PR 00769

Mailing address

PO Box 2156
Coamo, PR 00769-4156
Phone (787) 803-3636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150810001556 PR Part B Supplier - Clinic/Group Practice 7214242908 Receives reassigned benefits from 1 practitioner
Practice locations: Coamo, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1679964373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2156",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "007694156",
            "telephone_number": "787-803-3636",
            "fax_number": "787-803-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 CALLE JOSE I QUINTON",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "00769",
            "telephone_number": "787-803-3636",
            "fax_number": "787-803-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTO CARDIOVASCULAR DE COAMO, CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-17",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "DIAZ DIAZ",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-803-3636",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PR",
            "license": "12894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coamo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.