Provider Demographics
NPI:1184336067
Name:IAM PRIMARY CARE LLC
Entity type:Organization
Organization Name:IAM PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AUGUSTO
Authorized Official - Middle Name:J
Authorized Official - Last Name:AYALA CAMINERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-585-2411
Mailing Address - Street 1:PO BOX 2074
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-2074
Mailing Address - Country:US
Mailing Address - Phone:787-585-2411
Mailing Address - Fax:
Practice Address - Street 1:REGENCY PARK
Practice Address - Street 2:CALLE CARRAZO 155 8A
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00971
Practice Address - Country:US
Practice Address - Phone:787-585-2411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty