# SOUTHERN PATHOLOGY SERVICES, INC.

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

## Provider details

- **NPI number:** 1134119233
- **Authorized official:** GIOVANNA VAQUER (BILLING DIRECTOR)
- **Authorized official phone:** (787) 841-8645

## Contact information

- **Practice address:** 234 DAIGUE INDUSTRIAL SABANETIS, PONCE, PR 00715
- **Practice address phone:** (787) 841-8640
- **Practice address fax:** (787) 043-3464
- **Mailing address:** PO BOX 10729, PONCE, PR 00732-0729
- **Mailing address phone:** (787) 841-0042
- **Mailing address fax:** (787) 843-3464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0101X | Anatomic Pathology Physician | — | NULL | Yes |
| 207ZP0101X | Anatomic Pathology Physician | — | — | Yes |
| 207ZP0105X | Clinical Pathology/Laboratory Medicine Physician | — | NULL | — |
| 207ZP0105X | Clinical Pathology/Laboratory Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 10/28/2005
- **Last updated:** 04/14/2020