Mi Medico Primario, LLC
Clinic/Center, Primary Care in Fajardo, PR. Organization (NPI-2).
NPI number1356972111
StatusActive
Last updated in NPPESFeb 3, 2020
Details
- NPI
- 1356972111
- Entity type
- Organization (NPI-2)
- Legal business name
- Mi Medico Primario, LLC
- Organization subpart
- No
- Enumeration date
- Jan 30, 2020
- Certification date
- Feb 3, 2020
- Last updated
- Feb 3, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
| 261QH0100X | Clinic/Center, Health Services | – | – |
Practice location
410 Ave General Valero Ste 307Fajardo, PR 00738-3982
Phone 787-863-4058 · Fax 787-801-7344
Mailing address
410 Ave General Valero Ste 307Fajardo, PR 00738-3982
Phone 787-863-4058 · Fax 787-801-7344
Authorized official
Jose Antonio Rosario
President
7874036333
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All 7 Primary Care Clinic/Center providers in Fajardo · All 558 providers in Fajardo
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