Basic Information
Provider Information
NPI: 1548493729
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VARGAS-OTERO
FirstName: PEDRO
MiddleName: ENRIQUE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 29134
Address2: CARDIOLOGIA RCM
City: SAN JUAN
State: PR
PostalCode: 009290134
CountryCode: US
TelephoneNumber: 7877540101
FaxNumber: 7877587953
Practice Location
Address1: CENTRO MEDICO DE PUERTO RICO BO MONACILLOS
Address2: CENTRO CARDIOVASCULAR DE PUERTO RICO Y EL CARIBE STE 4
City: SAN JUAN
State: PR
PostalCode: 009350001
CountryCode: US
TelephoneNumber: 7877548500
FaxNumber: 7877587953
Other Information
ProviderEnumerationDate: 09/03/2009
LastUpdateDate: 09/09/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X18503PRN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0000X18503PRY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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