# CLINICA DE MEDICINA PRIMARIA DEL SUR.CSP

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

## Provider details

- **NPI number:** 1285979633
- **Authorized official:** MRS. SONIA A JOSE (RESIDENT AGENT)
- **Authorized official phone:** (787) 284-6934

## Contact information

- **Practice address:** CARR 132, KM 24.3 NO. 8, CANAS, PONCE, PR 00728
- **Practice address phone:** (787) 284-6934
- **Mailing address:** 442,CALLE HNOS SCHMIDT, EST DEL GOLF CLUB, PONCE, PR 00730

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 11906 | PR | Yes |

## Other

- **Enumeration date:** 12/11/2012
- **Last updated:** 12/11/2012