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General NPI Number Information
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NPI Number | 1659629418
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Entity Type | Organization
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Legal Business Name | PRIMARY QUALITY PARTNERS LLC
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Dates
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Enumeration Date | 08/27/2012
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Last Update Date | 08/27/2012
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Provider Practice Location Address
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Address Line | BAYAMON MEDICAL MALL # J23
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City | BAYAMON
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State | PR
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Zip | 00959-7200
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Country | US
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Telephone | 787-778-5353
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Fax | 787-778-5302
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Provider Business Mailing Address
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Address Line | PO BOX 6350
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City | BAYAMON
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State | PR
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Zip | 00960-5350
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Country | US
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Telephone | 787-778-5353
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Fax | 787-778-5302
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. JOSE J VARGAS DE LEON
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Credential |
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Telephone | 787-778-5354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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