# PRIMARY MEDICAL GROUP, C.S.P.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104216050
- **Authorized official:** DR. IRAIDA DEL RIO RODRIGUEZ M.D. (PRESIDENT)
- **Authorized official phone:** (787) 813-0080

## Contact information

- **Practice address:** CALLE MENDEZ VIGO \#24, PONCE, PR 00733
- **Practice address phone:** (787) 842-0005
- **Practice address fax:** (787) 984-2213
- **Mailing address:** PO BOX 336149, PONCE, PR 00733-6149
- **Mailing address phone:** (787) 813-0080
- **Mailing address fax:** (787) 840-8874

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/30/2015
- **Last updated:** 01/30/2015