Healthcare Provider Details

I. General information

NPI: 1275693582
Provider Name (Legal Business Name): PRIMARY & INTERNAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 01/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 CALLE BETANCES
SANTA ISABEL PR
00757-2619
US

IV. Provider business mailing address

PO BOX 1600
SANTA ISABEL PR
00757-1600
US

V. Phone/Fax

Practice location:
  • Phone: 787-845-3649
  • Fax: 787-845-4511
Mailing address:
  • Phone: 787-845-3946
  • Fax: 787-845-4511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID RAFAEL QUESTELL ALVARADO
Title or Position: PRESIDENT
Credential: MD
Phone: 787-845-3946