# PONCE PLASTIC SURGERY AND PAIN MANAGEMENT CENTER CORP

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

## Provider details

- **NPI number:** 1477913556
- **Authorized official:** ROBERTO PEREZ MD (PRESIDENTE)
- **Authorized official phone:** (787) 840-1114

## Contact information

- **Practice address:** 909 AVE TITO CASTRO STE 805, 909 AVE TITO CASTRO SUITE \#805, PONCE, PR 00716-4725
- **Practice address phone:** (787) 840-1114
- **Practice address fax:** (787) 842-6661
- **Mailing address:** 909 AVE TITO CASTRO STE 805, TORRE MEDICA SAN LUCAS, PONCE, PR 00716-4725
- **Mailing address phone:** (787) 840-1114
- **Mailing address fax:** (787) 842-6661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 38 | PR | Yes |

## Other

- **Enumeration date:** 03/02/2016
- **Last updated:** 03/02/2016