# BOULEVARD CARDIOVASCULAR DIAGNOSTIC INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164691705
- **Authorized official:** MRS. JULISSA MARTORELL (ADMINISTRATOR)
- **Authorized official phone:** (787) 795-8855

## Contact information

- **Practice address:** LAS PALMAS VILLAGE CALLE 19 ESQUINA A, LOCAL 3, CATANO, PR 00962-0000
- **Practice address phone:** (787) 795-8855
- **Practice address fax:** (888) 612-9595
- **Mailing address:** PO BOX 1203, SABANA SECA, PR 00952-1203
- **Mailing address phone:** (787) 795-8855
- **Mailing address fax:** (888) 612-9595

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/28/2008
- **Last updated:** 01/20/2015