| Ponce Services Corporation Inc | |
|
6595 Nw 36th St Suite 315 Virginia Gardens FL 33166-6979 | |
| (305) 244-3967 | |
| Not Available |
| Full Name | Ponce Services Corporation Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 6595 Nw 36th St, Virginia Gardens, Florida |
| Authorized Official Name and Position | Luz Mary Sabogal (PRESIDENT) |
| Authorized Official Contact | 3052443967 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ponce Services Corporation Inc 6595 Nw 36th St Suite 315 Virginia Gardens FL 33166-6979 Ph: (305) 244-3967 | Ponce Services Corporation Inc 6595 Nw 36th St Suite 315 Virginia Gardens FL 33166-6979 Ph: (305) 244-3967 |
| NPI Number | 1174685879 |
|---|---|
| Provider Enumeration Date | 12/16/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174685879 | NPI | - | NPPES |
| HCC5507 | Other | FL | AHCA CERTIFICATE OF EXEMP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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