# HEALTH SOUTH PRIMARY CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114285103
- **Authorized official:** MS. DENISSE GONZALEZ (PRESIDENT)
- **Authorized official phone:** (787) 284-6184

## Contact information

- **Practice address:** TORRE MED SAN LUCAS, PONCE, PR 00716-4728
- **Practice address phone:** (787) 284-6184
- **Mailing address:** PO BOX 800942, COTO LAUREL, PR 00780-0942

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/26/2012
- **Last updated:** 04/26/2012