L. A Primary Care & Specialty Group, Llc | |
100 Calle Del Muelle Capitolio Plaza Torre 1 1503 San Juan PR 00901-2616 | |
(787) 226-6359 | |
Not Available |
Full Name | L. A Primary Care & Specialty Group, Llc |
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Speciality | Family Medicine |
Location | 100 Calle Del Muelle, San Juan, Puerto Rico |
Authorized Official Name and Position | Ramon Luis Lopez Acosta (PRESIDENT) |
Authorized Official Contact | 7872266359 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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L. A Primary Care & Specialty Group, Llc Po Box 11395 San Juan PR 00922-1395 Ph: (787) 226-6359 | L. A Primary Care & Specialty Group, Llc 100 Calle Del Muelle Capitolio Plaza Torre 1 1503 San Juan PR 00901-2616 Ph: (787) 226-6359 |
NPI Number | 1730531534 |
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Provider Enumeration Date | 07/06/2016 |
Last Update Date | 07/06/2016 |
Medicare PECOS PAC ID | 0547645251 |
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Medicare Enrollment ID | O20220916000612 |
Identifier | Type | State | Issuer |
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1730531534 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 09645 (Puerto Rico) | Primary |
Provider Name | Ramon L Lopez Acosta |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1649363581 PECOS PAC ID: 1456536473 Enrollment ID: I20110505000820 |
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