# SOUTHERN RETINA CONSULTANTS PSC

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

## Provider details

- **NPI number:** 1154314292
- **Authorized official:** DR. JORGE H GUTIERREZ-DORRINGTON M.D. (PRESIDENT)
- **Authorized official phone:** (787) 842-2512

## Contact information

- **Practice address:** 909 AVE TITO CASTRO, SUITE 709, PONCE, PR 00716-4728
- **Practice address phone:** (787) 842-2512
- **Practice address fax:** (787) 840-6966
- **Mailing address:** PO BOX 801089, COTO LAUREL, PR 00780-1089
- **Mailing address phone:** (787) 842-2512
- **Mailing address fax:** (787) 840-6966

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 11622 | PR | Yes |

## Other

- **Enumeration date:** 08/24/2005
- **Last updated:** 03/25/2009