Organization
PRIMARY INTERNAL CARE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGARDO BAEZ AYALA (MD INTERNAL MEDICINE)
(939) 717-9840
Entity
Organization
Contact information
Practice address
PLAZA ISABELLA LOCAL 2 BO MACHUCHAL, SABANA GRANDE, PR 00637
(939) 717-9840
Mailing address
PRADERAS DE RIO FLORES 113, SABANA GRANDE, PR 00637
(939) 717-9840
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
15719
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EK244A
PTAN MEDICARE
PR
Enumeration date
01/24/2013
Last updated
01/30/2013
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