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SOUTHWEST OTO AND HEAD & NECK SURGERYPSC NPI 1891104188


NPI Information

NPI: 1891104188
Provider Name: SOUTHWEST OTO AND HEAD & NECK SURGERY,PSC
Classification: Otolaryngology - 207YX0007X
Entity Type: Organization

Specialization: Plastic Surgery within the Head & Neck

Address:
TORRE MED SAN LUCAS
AVE. TITO CASTRO
PONCE, PR
ZIP 00716
Phone: (787) 290-3333
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SOUTHWEST OTO AND HEAD & NECK SURGERY,PSC is a plastic surgery within the head and neck otolaryngology in Ponce, PR. The provider is an otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. SOUTHWEST OTO AND HEAD & NECK SURGERY,PSC NPI is 1891104188. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

TORRE MED SAN LUCAS
AVE. TITO CASTRO
PONCE, PR
ZIP 00716-728
Phone: (787) 290-3333
Fax: (787) 290-4444

The provider's authorized official is Edgar Domenech Fagundo .
The authorized official title is Owner and has the following contact phone number (787) 290-3333.

The enumeration date for this NPI number is 8/12/2014 and was last updated on 8/12/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207YX0007XOtolaryngologyPlastic Surgery within the Head & Neck13247PUERTO RICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10020400MEDICARE PINPUERTO RICO
2G76827MEDICARE UPINPUERTO RICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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