# SOUTH PEARL MEDICAL CORP

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

## Provider details

- **NPI number:** 1801379052
- **Authorized official:** SARA MIRANDA (PRESIDENT)
- **Authorized official phone:** (787) 903-4999

## Contact information

- **Practice address:** 39 CALLE MAYOR, PONCE, PR 00730-3761
- **Practice address phone:** (787) 437-1601
- **Mailing address:** 909 AVE TITO CASTRO STE 714, PONCE, PR 00716-4722

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/13/2018
- **Last updated:** 09/13/2018