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General NPI Number Information
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NPI Number | 1093926834
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Entity Type | Organization
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Legal Business Name | DE MEDICOS PRIMARIOS, CORP.
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 10/01/2013
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Provider Practice Location Address
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Address Line | 14 CALLE BETANCES
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City | SANTA ISABEL
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State | PR
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Zip | 00757-2632
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Country | US
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Telephone | 787-845-6000
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Fax | 787-845-8014
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Provider Business Mailing Address
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Address Line | PO BOX 816
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City | SANTA ISABEL
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State | PR
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Zip | 00757-0816
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Country | US
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Telephone | 787-845-6000
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Fax | 787-845-8014
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANGEL GABRIEL PAGAN
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Credential | M.D.
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Telephone | 787-845-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 12337
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License Number State | PR
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