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Organization
SOUTH CANCER GROUP PSC
Active
Organization
SOUTH CANCER GROUP PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE I RODRIGUEZ LUGO MD (PRESIDENT)
(787) 651-6010
Entity
Organization
Contact information
Practice address
917 AVE TITO CASTRO, TORRE MEDICA SAN LUCAS SUITE 508, PONCE, PR 00716
(787) 651-6010
(787) 651-6309
Mailing address
609 AVE TITO CASTRO, SUITE 102 PMB 464, PONCE, PR 00716
(787) 651-6010
(787) 651-6309
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QX0200X
Oncology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14399
STATE LICENSE
PR
Enumeration date
10/03/2018
Last updated
10/03/2018
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