OrganizationActive
Southwest Oto and Head & Neck Surgery,psc
NPI 1891104188 · Plastic Surgery within the Head & Neck (Otolaryngology) Physician · Ponce, PR
Provider details
- NPI number
- 1891104188
- Entity type
- Organization
- Primary specialty
- Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Edgar Domenech Fagundo, Owner(787) 290-3333
- License
- 13247 (PR)
Specialties & taxonomies
- Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianPrimary207YX0007XLicense 13247 (PR)
Allopathic & Osteopathic Physicians
Practice location
Torre Med San Lucas
Ave. Tito Castro
Ponce, PR 00716-4728
Phone: (787) 290-3333
Fax: (787) 290-4444
Mailing address
Po Box 2000
Mercedita, PR 00715
Registry dates
- Enumerated
- 2014-08-12
- Last updated
- 2014-08-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.