Southern Retina Consultants PSC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

11622 Issued in PR

Legal business name

SOUTHERN RETINA CONSULTANTS PSC

Practice address

909 Ave Tito Castro
Suite 709
Ponce, PR 00716-4728

Phone

(787) 842-2512

Fax

(787) 840-6966

NPI assigned

Aug 24, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jorge H Gutierrez-Dorrington, M.D.NPI 1316067200

Title

President

Phone

(787) 842-2512

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jorge H Gutierrez-Dorrington, MD

  • Ophthalmology Physician
  • Ponce, PR
  • NPI 1316067200
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1154314292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801089",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "007801089",
            "telephone_number": "787-842-2512",
            "fax_number": "787-840-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 AVE TITO CASTRO",
            "address_2": "SUITE 709",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007164728",
            "telephone_number": "787-842-2512",
            "fax_number": "787-840-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN RETINA CONSULTANTS PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ-DORRINGTON",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-842-2512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "PR",
            "license": "11622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Internal Medicine Institute
• Southern Internal Medicine, P.S.C
• Southern Pathology Services, Inc.
• Southern Pathology Services, Inc. (Laboratorio Clinico y Molecular Southern Pathology Services, Inc.)
• Southern Regional Blood Bank (Puerto Rico Blood Bank)
• Southern Surgical Group LLC
• Southern Surgicenter
• Southwest Oto and Head & Neck Surgery,PSC
• Southwestern Cardiology Group, Inc
• Special Tactics and Rescue Services Corp

• Ophthalmology Physician in Ponce, PR
• Providers in Ponce, PR by specialty
• Ophthalmology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.