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General NPI Number Information
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NPI Number | 1275266074
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Entity Type | Organization
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Legal Business Name | SENIOR PRIMARY MEDICINE INC
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Dates
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Enumeration Date | 07/08/2022
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Last Update Date | 10/20/2023
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Provider Practice Location Address
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Address Line | NARANJITO SHOOPING VILLAGE BO.CEDRO ARRIBA CARR 152 KM
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City | NARANJITO
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State | PR
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Zip | 00719
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Country | US
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Telephone | 939-274-9637
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Fax |
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Provider Business Mailing Address
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Address Line | HC 71 BOX 3305
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City | NARANJITO
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State | PR
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Zip | 00719-9532
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Country | US
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Telephone | 787-452-1572
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Fax |
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Authorized Official
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Title or Position | ADMINISTRADORA
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Name | MRS. GREGMARIE LOPEZ
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Credential |
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Telephone | 939-274-9637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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