Centro de Medicina Primaria VA
Organization Active NPI General Practice Physician · Vega Alta, PR
NPI 1184708448 · NPPES record last updated Feb 25, 2026
Key facts
- NPI
- 1184708448
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- CENTRO DE MEDICINA PRIMARIA VA
- Practice address
- Calle Luis Munoz Rivera
#3
Vega Alta, PR 00692 - Phone
- (787) 883-0124
- Fax
- (787) 883-7645
- NPI assigned
- Oct 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Mildalias Dominguez Pascual, M.D.
- Title
- President
- Phone
- (787) 883-0124
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 3
Practitioners 16
-
Jose Alvarez, M.D.
-
Fernando A. Garcia-Cruz, M.D.
-
Vivian Lopez Lorenzo, M.D.
-
Glorymar Ortiz Cordero, M.D.
-
Lorenzo Rivera, MD
-
Kareen T. Tirado, M.D.
-
Blanca Salas Bosque, M.D.
-
Clara Reyes Diaz, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041109000668 | PR | Part B Supplier - Clinic/Group Practice | 2365405586 |
Receives reassigned benefits from 13 practitioners 1 other NPI on this enrollment Practice locations: Vega Alta, PR |
National Provider Directory
- Tax ID family
- Centro de Medicina Primaria VA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
Calle Luis Munoz Rivera
#3
Vega Alta, PR 00692
Mailing address
PO Box 4317
Vega Baja, PR 00694-4317
Phone (787) 883-0124
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19197 | Other | PR | TRIPLE S |
Other providers in Vega Alta, PR
- Centro Ashtar de Terapia Fisica
- Centro Clinico de Vega Alta Corp
- Centro de Cuidados Preventivos Las Vegas LLC
- Centro de Imagen
- Centro de Medicina Primaria VA
- Centro de Vacunacion del Norte LLC
- Centro Dr. Edwin F. Girau Nieves
- Centro Imagen
- Centro Medicina Primaria Vega Alta
- Centro Medicina Primaria Vega Alta
All providers in Vega Alta, PR · General Practice Physician 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 25, 2026. 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.