Organization
PRIMARY MEDICAL GROUP SAN CRISTOBAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SERGIO CHEVERE M.D. (VICEPRESIDENT)
(787) 813-0080
Entity
Organization
Contact information
Practice address
34 CALLE MENDEZ VIGO, PONCE, PR 00730-3697
(787) 813-0080
(787) 840-8874
Mailing address
PO BOX 336149, PONCE, PR 00733-6149
(787) 813-0080
(787) 840-8874
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0082083
PROVIDER NUMBER
PR
Enumeration date
04/02/2013
Last updated
04/04/2013
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