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Organization
CENTRO DE MEDICINA PRIMARIA VA
Active
Organization
CENTRO DE MEDICINA PRIMARIA VA
Active
Other names
CENTRO DE MEDICINA PRIMARIA VA
Organization subpart
No
Provider details
NPI number
Authorized official
MILDALIAS DOMINGUEZ (PRESIDENT)
(787) 883-0124
Entity
Organization
Contact information
Practice address
CALLE LUIS MUNOZ RIVERA 3, VEGA ALTA, PR 00692
(787) 883-0124
(787) 883-0222
Mailing address
PO BOX 4317, VEGA BAJA, PR 00694-4317
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10F2590
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4026060
OTHER ID NUMBER
—
Enumeration date
02/26/2008
Last updated
09/08/2008
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