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General NPI Number Information
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NPI Number | 1598884744
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Entity Type | Organization
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Legal Business Name | SOUTHERN HOSPITAL SERVICE INC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | CALLE LA CRUZ 6
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City | JUANA DIAZ
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State | PR
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Zip | 00795
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Country | US
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Telephone | 787-837-2265
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Fax | 787-260-1441
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Provider Business Mailing Address
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Address Line | PO BOX 1400
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City | JUANA DIAZ
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State | PR
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Zip | 00795
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Country | US
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Telephone | 787-837-2265
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Fax | 787-260-1441
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Authorized Official
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Title or Position | PRESIDENTE
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Name | ARMANDO L MUNOZ BERMUDEZ
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Credential |
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Telephone | 787-837-2265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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