Organization
PONCE ADVANCE MEDICAL GROUP NETWORK, CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS M IRIZARRY PABON MD (PRESIDENT)
(787) 813-2325
Entity
Organization
Contact information
Practice address
PMB 282, 1575 MUNOZ RIVERA AVE., PONCE, PR 00717
(787) 813-2325
(787) 841-3908
Mailing address
1266 AVE HOSTOS, ESQUINA POWER, PONCE, PR 00717-0947
(787) 813-2325
(787) 841-3908
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/22/2011
Last updated
07/22/2011
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