| Southeast Renal Group Psc | |
|
Santa Isabel Professional Bldg Suite 205 Santa Isabel PR 00757 | |
| (787) 971-7133 | |
| Not Available |
| Full Name | Southeast Renal Group Psc |
|---|---|
| Speciality | Internal Medicine |
| Location | Santa Isabel Professional Bldg, Santa Isabel, Puerto Rico |
| Authorized Official Name and Position | Luis A Ortiz Heredia (PRESIDENT) |
| Authorized Official Contact | 7879717133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Renal Group Psc Po Box 335432 Ponce PR 00733-5432 Ph: (787) 971-7133 | Southeast Renal Group Psc Santa Isabel Professional Bldg Suite 205 Santa Isabel PR 00757 Ph: (787) 971-7133 |
| NPI Number | 1821413527 |
|---|---|
| Provider Enumeration Date | 03/04/2014 |
| Last Update Date | 03/21/2017 |
| Medicare PECOS PAC ID | 0840517025 |
|---|---|
| Medicare Enrollment ID | O20150327000419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821413527 | NPI | - | NPPES |
| Provider Name | Luis A Ortiz Heredia |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1083810162 PECOS PAC ID: 9739254772 Enrollment ID: I20080826000454 |
| Provider Name | Felix W Perez Ramos |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1861641672 PECOS PAC ID: 1355588203 Enrollment ID: I20130513000403 |
| Provider Name | Orlando Camacho-geck |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1659684819 PECOS PAC ID: 3678851029 Enrollment ID: I20161105000136 |
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