Provider Demographics
NPI:1114030913
Name:SOUTHERN EKG SERVICES
Entity Type:Organization
Organization Name:SOUTHERN EKG SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ ARZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-813-1836
Mailing Address - Street 1:PO BOX 7819
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7819
Mailing Address - Country:US
Mailing Address - Phone:787-813-1836
Mailing Address - Fax:787-813-1836
Practice Address - Street 1:PONCE BY PASS 2217 AVE
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-813-1836
Practice Address - Fax:787-813-1836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR28398Medicare ID - Type UnspecifiedPROVIDER NUMBER