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SOUTHWEST OTO AND HEAD & NECK SURGERY,PSC
NPI 1891104188
Otolaryngology - Plastic Surgery within the Head & Neck in Ponce, PR

Active since August 12, 2014
TORRE MED SAN LUCAS, AVE. TITO CASTRO, PONCE, PR 00716(787) 290-3333(787) 290-4444 Get Directions Write a Review

NPPES record last updated: August 12, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southwest Oto And Head & Neck Surgery,psc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHWEST OTO AND HEAD & NECK SURGERY,PSC (NPI 1891104188) is a healthcare organization registered as a plastic surgery within the head & neck in Ponce, Puerto Rico and active in the NPI registry since August 2014. The organization lists Edgar Domenech Fagundo, Owner, as its authorized official.

NPPES Registry Identity

NPI1891104188
Entity TypeOrganization
Primary Taxonomy207YX0007X
Legal Business NameSOUTHWEST OTO AND HEAD & NECK SURGERY,PSC
Location AddressTORRE MED SAN LUCAS, AVE. TITO CASTROPonce, PR 00716-4728
Mailing AddressPo Box 2000, Pmb 137Mercedita, PR 00715 · (787) 290-3333 · Fax (787) 290-4444
Phone(787) 290-3333
Fax(787) 290-4444
Organization SubpartNo
Authorized OfficialEdgar Domenech FagundoOwner · (787) 290-3333
Enumeration DateAugust 12, 2014
✔ NPI 1891104188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Plastic Surgery within the Head & NeckAllopathic & Osteopathic Physicians
Taxonomy Code207YX0007X
License✔ Licensed in PR · 13247
Definition
An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.
TORRE MED SAN LUCAS, Ponce, PR 00716
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Other Identifiers 2

Medicare PIN0020400PR
Medicare UPING76827PR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEALTH SOUTH PRIMARY CLINIC
Clinic/Center
TORRE MED SAN LUCAS
PONCE, PR 00716
Ponce Municipio (787) 284-6184
ELSIE N LA TEXERA CSP
Clinic/Center
TORRE MED SAN LUCAS, AVENIDA TITO CASTRO SUITE 125
PONCE, PR 00716
Ponce Municipio (787) 651-1424
DR. JORGE I. RODRIGUEZ LUGO MD
Internal Medicine (Hematology & Oncology)
TORRE MED SAN LUCAS, 5TO PISO OFICINA 508
PONCE, PR 00716
Ponce Municipio (787) 385-8200
BREAST CANCER CARE, CSP
Clinic/Center (Oncology)
TORRE MED SAN LUCAS, , SUITES 508-509
PONCE, PR 00716
Ponce Municipio (787) 651-6010
FIRST CHOICE PROSTHETIC
Durable Medical Equipment & Medical Supplies
TORRE MED SAN LUCAS
PONCE, PR 00716
Ponce Municipio (787) 903-4999
SOUTH CANCER CENTER
Clinic/Center (Oncology)
TORRE MED SAN LUCAS, 5TO PISO OFICINA 508
PONCE, PR 00716
Ponce Municipio (787) 651-6010

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southwest Oto And Head & Neck Surgery,psc's NPI number?

The NPI number for Southwest Oto And Head & Neck Surgery,psc is 1891104188. It was assigned to this organization in the NPPES registry on August 12, 2014.

Where is Southwest Oto And Head & Neck Surgery,psc located?

Southwest Oto And Head & Neck Surgery,psc is located at Torre Med San Lucas Ave. Tito Castro, Ponce, PR 00716. The listed phone number is (787) 290-3333.

What is Southwest Oto And Head & Neck Surgery,psc's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Plastic Surgery within the Head & Neck, with taxonomy code 207YX0007X.

When was this NPI record last updated?

The NPPES record for Southwest Oto And Head & Neck Surgery,psc was last updated on August 12, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.