# SOUTHERN INTERNAL MEDICINE GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Internal Medicine Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780633651
- **Authorized official:** DR. PEDRO LUIS BENITEZ LORENZO M.D. (PRESIDENT)
- **Authorized official phone:** (787) 844-1248

## Contact information

- **Practice address:** 2225 PONCE BYE PASS STE 302, EDIFICIO PARRA, PONCE, PR 00717-1322
- **Practice address phone:** (787) 844-1248
- **Practice address fax:** (787) 290-0706
- **Mailing address:** PO BOX 7819, PONCE, PR 00732-7819
- **Mailing address phone:** (787) 844-1248
- **Mailing address fax:** (787) 290-0706

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/09/2006
- **Last updated:** 11/08/2018