Provider Demographics
NPI:1184351827
Name:PRIMARY INTERNAL MED LLC
Entity type:Organization
Organization Name:PRIMARY INTERNAL MED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NOELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-315-5855
Mailing Address - Street 1:F2 CALLE C
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-1136
Mailing Address - Country:US
Mailing Address - Phone:787-315-5855
Mailing Address - Fax:
Practice Address - Street 1:F2 CALLE C
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-1136
Practice Address - Country:US
Practice Address - Phone:787-315-5855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty