Organization Name: | PUERTO RICO PRIMARY HEALTH CARE INC |
NPI Number: | 1427457860 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | YATZMELLIE L VEGA (PRESIDENT) |
Mailing Address: | Healthcare Ambulatory Services, Plaza Del Carmen Mall Num. 26 Caguas |
State: | PR US |
Postal Code: | 007259998 |
Phone Number: | 7872866060 |
Fax Number: | |
NPI Enumeration Date: | 08/21/2014 |
NPI Last Update Date: | 09/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 18705 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |