Puerto Rico Primary Care Mso, Inc. - CDT Luquillo
Organization Active NPI Emergency Care Clinic/Center · Luquillo, PR
NPI 1134873235 · NPPES record last updated Feb 24, 2022
Key facts
- NPI
- 1134873235
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Care Clinic/Center 261QE0002X
- Legal business name
- PUERTO RICO PRIMARY CARE MSO, INC. - CDT LUQUILLO
- Practice address
- Calle 14 de Julio No 159
Bo Mata de Platano
Luquillo, PR 00773 - Phone
- (787) 885-4446
- Fax
- (787) 885-6129
- NPI assigned
- Feb 8, 2022
- Organization subpart
- No
Authorized official
- Name
- Keila Centeno
- Title
- Administrator
- Phone
- (787) 534-3789
Other NPIs on the same Medicare enrollment 2
Corporate family (same tax ID) 3
Practitioners 20
-
Victor H Cordero, MD
-
Gilberto J Encarnacion Lopez, GENERAL MEDICINE
-
Jose Luis Mendez, MD
-
Samuel Negron Agosto, M.D.
-
Jose Rosa, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230925002483 | PR | Part B Supplier - Clinic/Group Practice | 3274987268 |
Receives reassigned benefits from 19 practitioners 2 other NPIs on this enrollment Practice locations: Luquillo, PR |
National Provider Directory
- Tax ID family
- Puerto Rico Primary Care Mso Inc - CDT Luquillo
Locations
159 Calle Quinto Centenario
Luquillo, PR 00773
Phone (787) 500-7752
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Care Clinic/Center | 261QE0002X | Yes |
Addresses
Primary practice location
Calle 14 de Julio No 159
Bo Mata de Platano
Luquillo, PR 00773
Mailing address
PO Box 818
Ceiba, PR 00735-0818
Phone (787) 534-3789
Other providers in Luquillo, PR
- Isaura Perez
- Physical Medicine Consultants Centro Fisiatrico del Caribe
- Anabel Pizarro Rios
- Fernando Luis Pizarro
- Preds, Corp
- Puerto Rico Primary Care Mso, Inc. - Radiologia
- Puerto Rico Primary Care, Mso, Inc. - Laboratorio
- Elinette Ramirez
- Angeles Margarita Ramos
- Maria Reynoso
All providers in Luquillo, PR · Emergency Care Clinic/Center in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.