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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