Healthcare Provider Details

I. General information

NPI: 1528975174
Provider Name (Legal Business Name): SERVICIOS MEDICOS DEL SUR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2122 CALLE COLINA
PONCE PR
00730-4125
US

IV. Provider business mailing address

2122 CALLE COLINA
PONCE PR
00730-4125
US

V. Phone/Fax

Practice location:
  • Phone: 787-400-4802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLOS ANDRES MENDEZ CINTRON
Title or Position: CEO
Credential: MD
Phone: 787-400-4802