Organization
PUERTO RICO ONCOLOGY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE I RODRIGUEZ LUGO (PRESIDENT)
(787) 385-8200
Entity
Organization
Contact information
Practice address
5 AVENIDA HOSTOS SUR, PONCE, PR 00716
(787) 385-8200
Mailing address
609 AVE TITO CASTRO, STE 102 PMB 464, PONCE, PR 00716-0200
(787) 385-8200
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QX0200X
Oncology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14399
MEDICAL LICENSE
PR
Enumeration date
09/23/2016
Last updated
09/23/2016
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