Healthcare Provider Details

I. General information

NPI: 1659629418
Provider Name (Legal Business Name): PRIMARY QUALITY PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2012
Last Update Date: 08/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BAYAMON MEDICAL MALL # J23
BAYAMON PR
00959-7200
US

IV. Provider business mailing address

PO BOX 6350
BAYAMON PR
00960-5350
US

V. Phone/Fax

Practice location:
  • Phone: 787-778-5353
  • Fax: 787-778-5302
Mailing address:
  • Phone: 787-778-5353
  • Fax: 787-778-5302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE J VARGAS DE LEON
Title or Position: PRESIDENTE
Credential:
Phone: 787-778-5354