Provider Demographics
NPI:1003372319
Name:PRIMARY MEDICAL GROUP,C.S.P.
Entity Type:Organization
Organization Name:PRIMARY MEDICAL GROUP,C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL RIO RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-844-0331
Mailing Address - Street 1:PO BOX 336149
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00733-6149
Mailing Address - Country:US
Mailing Address - Phone:787-844-0331
Mailing Address - Fax:787-840-8874
Practice Address - Street 1:607 CALLE FERROCARRIL
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0000
Practice Address - Country:US
Practice Address - Phone:787-259-7219
Practice Address - Fax:787-848-9772
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRO DE URGENCIAS PRIMARY MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care