Basic Information
| Provider Information | |||||||||
| NPI: | 1235446287 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PRIMARY MANAGEMENT RESOURCES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 PARK CENTRE BLVD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331695373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056210023 | ||||||||
| FaxNumber: | 3056239188 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 PARK CENTRE BLVD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331695373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056210023 | ||||||||
| FaxNumber: | 3056239188 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2010 | ||||||||
| LastUpdateDate: | 09/10/2010 | ||||||||
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| AuthorizedOfficialLastName: | CERDEIRO | ||||||||
| AuthorizedOfficialFirstName: | FEDERICO | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 3056210023 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.