Md Premier Health Llc | |
Rio La Plata Mall Ste A3 Toa Alta PR 00953-1837 | |
(787) 870-2148 | |
(787) 870-7431 |
Full Name | Md Premier Health Llc |
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Speciality | General Practice |
Location | Rio La Plata Mall Ste A3, Toa Alta, Puerto Rico |
Authorized Official Name and Position | Rigoberto Gonzalez Jimenez (VICE PRESIDENT) |
Authorized Official Contact | 9396490848 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Md Premier Health Llc 97 Plaza Carmen Vega Alta PR 00692-9128 Ph: (939) 649-0848 | Md Premier Health Llc Rio La Plata Mall Ste A3 Toa Alta PR 00953-1837 Ph: (787) 870-2148 |
NPI Number | 1326754706 |
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Provider Enumeration Date | 01/27/2023 |
Last Update Date | 07/02/2024 |
Medicare PECOS PAC ID | 4385186311 |
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Medicare Enrollment ID | O20240606000222 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326754706 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Germariliz Diaz Martinez |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306251491 PECOS PAC ID: 6901129147 Enrollment ID: I20141219001609 |
Provider Name | Rigoberto Gonzalez Jimenez |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1114457009 PECOS PAC ID: 8921367160 Enrollment ID: I20180117000591 |
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