Prime Medical Center CSP

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

PRIME MEDICAL CENTER CSP

Practice address

47 Barcelo St.
Maunabo, PR 00707

Phone

(787) 861-0547

Fax

(787) 861-0547

NPI assigned

Nov 2, 2022

Last updated

Dec 18, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Pedro N Cadiz Miranda, MDNPI 1598383713

Title

General Practice

Phone

(787) 861-4800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PRIME MEDICAL CENTER CSP Former legal business name

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pedro N Cadiz Miranda, MD

  • General Practice Physician
  • Guayama, PR
  • NPI 1598383713
  Medicare reassignment NPD Authorized official
• Raul Enrique Martinez Munoz, M.D.

  • General Practice Physician
  • Maunabo, PR
  • NPI 1306810981
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1407563018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 598",
            "city": "MAUNABO",
            "state": "PR",
            "postal_code": "007070598",
            "telephone_number": "787-861-0547",
            "fax_number": "787-861-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 BARCELO ST.",
            "city": "MAUNABO",
            "state": "PR",
            "postal_code": "00707",
            "telephone_number": "787-861-0547",
            "fax_number": "787-861-0547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MEDICAL CENTER CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2024-12-18",
        "certification_date": "2022-10-29",
        "status": "A",
        "authorized_official_last_name": "CADIZ MIRANDA",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "GENERAL PRACTICE",
        "authorized_official_telephone_number": "787-861-4800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "8366",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIME MEDICAL CENTER CSP",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "PRIME MEDICAL CENTER CSP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Victor Moreno, MD
• Municipio de Maunabo
• Municipio de Maunabo
• Glorinell Perez Rodriguez
• PHM Multidisciplinary Clinic Maunabo LLC
• Rct21 Healthcare LLC
• Yves Resilard, M.D.
• Cristian Jose Rivera Milian
• Denise Y Rodriguez Steidel, M.D.
• Arleen Rodriguez, L.P.N.

• Public Health & General Preventive Medicine Physician in Maunabo, PR
• Providers in Maunabo, PR by specialty
• Public Health & General Preventive Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.