Healthcare Provider Details

I. General information

NPI: 1215654090
Provider Name (Legal Business Name): HORIZON PRIMARY CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 10/24/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB CATALANA CALLE GEORGETTI C-67
BARCELONETA PR
00617
US

IV. Provider business mailing address

PASEO CORALES II CALLE MAR NEGRO 787
DORADO PR
00646
US

V. Phone/Fax

Practice location:
  • Phone: 787-710-8812
  • Fax:
Mailing address:
  • Phone: 787-989-0414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ROBERTO MARTINEZ
Title or Position: PRIMARY OFFICIAL
Credential: PHD
Phone: 787-989-0414