Provider Demographics
NPI:1972034171
Name:PR WOUND CARE & PRIMARY MEDICINE CENTER LLC
Entity Type:Organization
Organization Name:PR WOUND CARE & PRIMARY MEDICINE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CIRINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-908-8118
Mailing Address - Street 1:6400 AVE ISLA VERDE
Mailing Address - Street 2:COND LOS PINOS 10F OESTE
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-7145
Mailing Address - Country:US
Mailing Address - Phone:787-908-8118
Mailing Address - Fax:
Practice Address - Street 1:F33 CALLE CLAVEL
Practice Address - Street 2:LOMAS VERDES
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-908-8118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service