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Organization
SOUTHERN CARDIOVASCULAR SURGERY
Active
Organization
SOUTHERN CARDIOVASCULAR SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALVADOR JIMENEZ MD (PRESIDENT)
(787) 840-4030
Entity
Organization
Contact information
Practice address
5 CALLE GUADALUPE, SAN LUCAS I, EDIF FRANCISCO REVS, PONCE, PR 00730-3111
(787) 840-4030
(787) 840-4310
Mailing address
PO BOX 330230, PONCE, PR 00733-0230
(787) 840-4030
(787) 840-4310
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
8605
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60100
CRUZ AZUL
PR
01
—
88703
SSS
—
01
—
9500000
HUMANA
—
Enumeration date
11/08/2005
Last updated
08/22/2020
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