| Organization Name: | SAN JOSE PRIMARY MEDICINE INC |
| NPI Number: | 1124417464 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDGARDO MARRERO PEREZ (PRESIDENT) |
| Mailing Address: | # 2 Street Km 94.1 Camuy |
| State: | PR US |
| Postal Code: | 00627 |
| Phone Number: | 7872624167 |
| Fax Number: | 7879334120 |
| NPI Enumeration Date: | 01/09/2015 |
| NPI Last Update Date: | 03/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |