# OFICINA MEDICA PRIMARIA DEL SUR CSP

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

## Provider details

- **NPI number:** 1134598337
- **Authorized official:** DR. JOSE E GONZALEZ MORENO MD (PRESIDENT)
- **Authorized official phone:** (787) 690-2644

## Contact information

- **Practice address:** 65 INFANTERIA A1, LOCAL ANEXO REMA, YAUCO, PR 00698
- **Practice address phone:** (787) 992-7199
- **Practice address fax:** (787) 992-7199
- **Mailing address:** PO BOX 446, GUANICA, PR 00653-0446
- **Mailing address phone:** (787) 992-7199
- **Mailing address fax:** (787) 992-7199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 16881 | PR | Yes |
| 208D00000X | General Practice Physician | 15915 | PR | — |

## Other

- **Enumeration date:** 09/17/2015
- **Last updated:** 09/17/2015