# SOUTH PRIME OB-GYN LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Prime OB-GYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023664042
- **Authorized official:** DR. LENNY G PAGAN MD (PRESIDENT)
- **Authorized official phone:** (787) 633-9260

## Contact information

- **Practice address:** HOSPITAL DAMAS, 2213 PONCE BYPASS, PONCE, PR 00717
- **Practice address phone:** (787) 633-9260
- **Mailing address:** 1124 AVE MUNOZ RIVERA, PONCE, PR 00717-0643
- **Mailing address phone:** (787) 633-9260

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VX0000X | Obstetrics Physician | — | NULL | Yes |
| 207VX0000X | Obstetrics Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/15/2019
- **Last updated:** 08/15/2019