Organization Active NPI

Innovative Cardiology Center LLC

  • Cardiovascular Disease Physician
  • Caguas, PR
National Provider Identifier
1982184941
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
18640 Issued in PR
Legal business name
INNOVATIVE CARDIOLOGY CENTER LLC
Practice address
Hima Plaza 1 Ofic 305
100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone
(787) 920-4090
NPI assigned
Aug 20, 2018
Last updated
Aug 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Authorized official

Name
Bladimir Sanchez Perez, MDNPI 1710270897
Title
Presidente
Phone
(787) 354-7853

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 18640 PR Primary

Addresses

Primary practice location

Hima Plaza 1 Ofic 305
100 Ave Luis Munoz Marin
Caguas, PR 00725

Mailing address

Cond Regency Park Apt 305 3F
155 Calle Carazo
Guaynabo, PR 00971
Phone (787) 354-7853

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190418000351 PR Part B Supplier - Clinic/Group Practice 4183965239 Receives reassigned benefits from 1 practitioner
Practice locations: Humacao, PR

National Provider Directory

National Provider Directory

Locations

100 Ave Luis Munoz Marin
Ofc 305
Caguas, PR 00725
Phone (787) 920-4090

Practitioners & affiliated clinicians

Practitioners 1

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": "1534723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534723200000",
    "number": "1982184941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND REGENCY PARK APT 305 3F",
            "address_2": "155 CALLE CARAZO",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00971",
            "telephone_number": "787-354-7853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIMA PLAZA 1 OFIC 305",
            "address_2": "100 AVE LUIS MUNOZ MARIN",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-920-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE CARDIOLOGY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ PEREZ",
        "authorized_official_first_name": "BLADIMIR",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-354-7853",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PR",
            "license": "18640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.