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Organization
SOUTH CANCER CENTER
Active
Organization
SOUTH CANCER CENTER
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
TORRE MED SAN LUCAS, 5TO PISO OFICINA 508, PONCE, PR 00716-4728
(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
261QM1300X
Multi-Specialty Clinic/Center
14399
PR
261QX0200X
Oncology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14399
LICENSE NUMBER
PR
Enumeration date
12/01/2011
Last updated
05/31/2016
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