MEDICARE: SOUTHERN CARDIOVASCULAR SURGERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	8605	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9500000	OTHER		HUMANA
2	60100	OTHER	PR	CRUZ AZUL
3	88703	OTHER		SSS

General Provider Information

NPI Number	:	1548241482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN CARDIOVASCULAR SURGERY

Provider Business Mailing Address
First Line	:	PO BOX 330230
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00733-0230
Country	:	US
Telephone Number	:	787-840-4030
Fax Number	:	787-840-4310

Provider Business Practice Location Address
First Line	:	5 CALLE GUADALUPE
Second Line	:	SAN LUCAS I, EDIF FRANCISCO REVS
City	:	PONCE
State	:	PR
Zip	:	00730-3111
Country	:	US
Telephone Number	:	787-840-4030
Fax Number	:	787-840-4310

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SALVADOR JIMENEZ
Credential	:	MD
Telephone Number	:	787-840-4030

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1184908139 — BLOSSOM : DEVELOPMENTAL THERAPY ASSOCIATES
Practice Location Address:

3111 PONCE DE LEON
CORAL GABLES, FL
33134

Practice Phone: 305-444-9807
Practice Fax: 305-444-9808

1508130816 — MRS. DEBORAH SOCORRO CUZA COTA/L
Practice Location Address:

3111 PONCE DE LEON BLVD
CORAL GABLES, FL
33134-6816

Practice Phone: 305-444-9807
Practice Fax: 305-444-9808

1841116811 — RC ADVANCED RADIOTHERAPY LLC
Practice Location Address:

1798 CALLE LLANURA
PONCE, PR
00730-4141

Practice Phone: 787-602-1122
Practice Fax:

1205752862 — MARIA S BORRAS SANTOS
Practice Location Address:

344 CALLE NOVICIA
PONCE, PR
00730-3910

Practice Phone: 787-316-2868
Practice Fax:

1154975688 — JAIRA MARIE ALMODOVAR MEDINA PSYD
Practice Location Address:

35 CALLE MAYOR
PONCE, PR
00730-3726

Practice Phone: 787-844-3077
Practice Fax:

1578496691 — MILAY ARROYO
Practice Location Address:

111 CALLE VENUS
PONCE, PR
00730-2854

Practice Phone: 939-209-8733
Practice Fax:

Directions to “SOUTHERN CARDIOVASCULAR SURGERY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.