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General NPI Number Information
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NPI Number | 1417927898
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Entity Type | Organization
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Legal Business Name | PRIMARY MEDICAL CENTER INC
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | CALLE FERROCARRIL # 607
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City | PONCE
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State | PR
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Zip | 00717-1195
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Country | US
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Telephone | 787-813-0080
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Fax | 787-840-8874
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Provider Business Mailing Address
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Address Line | PO BOX 336149
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City | PONCE
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State | PR
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Zip | 00733-6149
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Country | US
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Telephone | 787-813-0080
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Fax | 787-840-8874
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Authorized Official
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Title or Position | PRESIDENTE
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Name | SERGIO CHEVERE
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Credential | M.D.
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Telephone | 787-813-0080
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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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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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