Healthcare Provider Details

I. General information

NPI: 1568344901
Provider Name (Legal Business Name): SOUTH-CENTRAL EMERGENCY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/25/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL MENONITA CAYEY BO RINCON SECT LOMAS CARR 14
CAYEY PR
00736-0001
US

IV. Provider business mailing address

PO BOX 3504
JUNCOS PR
00777-3504
US

V. Phone/Fax

Practice location:
  • Phone: 787-207-7900
  • Fax:
Mailing address:
  • Phone: 787-207-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSE ORLANDO RIVERA RIVERA
Title or Position: M.D.
Credential: M.D.
Phone: 787-207-7900