| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 01/27/2023 |
| Last Update Date | 07/02/2024 |
| Certification Date | 07/02/2024 |
| Medicare PECOS PAC ID | 4385186311 |
|---|---|
| Medicare Enrollment ID | O20240606000222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326754706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (NU) | Primary |
| Provider Name | Germariliz Diaz Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306251491 PECOS PAC ID: 6901129147 Enrollment ID: I20141219001609 |
| Provider Name | Rigoberto Gonzalez Jimenez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114457009 PECOS PAC ID: 8921367160 Enrollment ID: I20180117000591 |
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