This might be the Puerto Rico job(s) that keep getting posted at CareerMD.com, or at least something similar.
http://www.careermd.com/physicians/viewlisting.aspx?listingid=288999224&userid=1213926&nltitleid=22
Although, one of our junior faculty interviewed in PR, at one of the LCME med schools there I think, on a lark (hey, free trip to the Caribbean) and said that while Spanish was helpful, it was not required since lectures were in English, and they said you'd become functionally conversant quick enough.
I have a very hard time imagining a US-based practice that would actually
require Spanish fluency even in far south CA/AZ/TX/FL. Maybe in Miami there are enough Spanish-first professional people (physicians and non-physicians) to make up a pathology practice.