Organization
SOUTHERN AESTHETICS CORP.PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSENDO EMILIO MARTINEZ MD (PRESIDENT)
(787) 840-9450
Entity
Organization
Contact information
Practice address
2225 PONCE BYP, SUITE 401, PONCE, PR 00717-1321
(787) 840-9450
(787) 840-9454
Mailing address
2225 PONCE BYPASS, SUITE 401, PONCE, PR 00717-1322
(787) 840-9450
(787) 840-9454
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
326185
PR
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
06/20/2013
Last updated
06/16/2018
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