Provider Demographics
NPI:1649946591
Name:BLESSING PRIMARY CARE LLC
Entity type:Organization
Organization Name:BLESSING PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERARI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-349-7243
Mailing Address - Street 1:PO BOX 5000 PMB 638
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-5000
Mailing Address - Country:US
Mailing Address - Phone:787-544-6745
Mailing Address - Fax:787-680-1941
Practice Address - Street 1:CARR 486 KM 17 BO ZANJAS INT
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-544-6745
Practice Address - Fax:787-680-1941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty