Healthcare Provider Details

I. General information

NPI: 1962825893
Provider Name (Legal Business Name): PRIMA IMAGING, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

Z40 AVE LAUREL LOMAS VERDES URB LOMAS VERDES
BAYAMON PR
00956-0000
US

IV. Provider business mailing address

PO BOX 3161
BAYAMON PR
00960-3161
US

V. Phone/Fax

Practice location:
  • Phone: 787-785-1011
  • Fax: 787-286-7572
Mailing address:
  • Phone: 787-787-7411
  • Fax: 787-286-7572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAREN M RIVERA
Title or Position: CONTACT PERSON
Credential:
Phone: 787-506-4161