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Contact Information

SOUTHWEST OTO AND HEAD & NECK SURGERY,PSC
TORRE MED SAN LUCAS
AVE. TITO CASTRO
PONCE, PR00716-4728
 Phone: 787-290-3333
 Fax: 787-290-4444
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for SOUTHWEST OTO AND HEAD & NECK SURGERY,PSC

NPI Number 1891104188
LBN Legal business name SOUTHWEST OTO AND HEAD & NECK SURGERY,PSC
Authorized official EDGAR DOMENECH FAGUNDO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/12/2014
Last updated 08/12/2014 - About 12 years ago
Identifiers
PR License # 13247
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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