NPIMap

Organization Active NPI

Southern Aesthetics Corp.PSC

  • Clinic/Center
  • Ponce, PR
National Provider Identifier
1205275484
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
326185 Issued in PR
Legal business name
SOUTHERN AESTHETICS CORP.PSC
Practice address
2225 Ponce Byp
Suite 401
Ponce, PR 00717-1321
Phone
(787) 840-9450
Fax
(787) 840-9454
NPI assigned
Jun 20, 2013
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Rosendo Emilio Martinez, MDNPI 1134189400
Title
President
Phone
(787) 840-9450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Clinic/Center 261Q00000X 326185 PR Primary

Addresses

Primary practice location

2225 Ponce Byp
Suite 401
Ponce, PR 00717-1321

Mailing address

2225 Ponce Bypass
Suite 401
Ponce, PR 00717-1322
Phone (787) 840-9450

National Provider Directory

National Provider Directory

Locations

2225 Ponce Byp
Ste 401
Ponce, PR 00717
Phone (787) 840-9450

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1205275484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 PONCE BYPASS",
            "address_2": "SUITE 401",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171322",
            "telephone_number": "787-840-9450",
            "fax_number": "787-840-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 PONCE BYP",
            "address_2": "SUITE 401",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171321",
            "telephone_number": "787-840-9450",
            "fax_number": "787-840-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN AESTHETICS CORP.PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-20",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ROSENDO",
        "authorized_official_middle_name": "EMILIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-840-9450",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PR",
            "license": "326185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.