Organization
SOUTHERN SURGICENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX CEDENO (ADMINISTRATOR)
(787) 841-0303
Entity
Organization
Contact information
Practice address
2213 PONCE BYP, EDIF PARRA SUITE 201, PONCE, PR 00717-1318
(787) 841-0303
Mailing address
2213 PONCE BYP, EDIF PARRA SUITE 201, PONCE, PR 00717-1318
(787) 841-0303
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18512
TRIPLE S
PR
01
—
2873
INT MEDICAL CARD
PR
01
—
30176
CRUZ AZUL
PR
01
—
30512
CFSE
PR
01
—
40124
PREFFERED MEDICARE CHOICE
PR
01
—
5501148
ACAA
PR
01
—
70170
MCS
PR
01
—
850011
MMM HEALTHCARE
PR
Enumeration date
08/17/2006
Last updated
01/15/2009
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