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Individual

SUSAN BROWN PONCY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1004 S OLD DIXIE HWY, SUITE 201, JUPITER, FL 33458-7200
(561) 745-7094
(561) 741-5584
Mailing address
1004 S OLD DIXIE HWY, SUITE 201, JUPITER, FL 33458-7200
(561) 745-7094
(561) 741-5584

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME80003
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
269268600
FL
01
51886
BCBS
FL
Enumeration date
07/12/2006
Last updated
03/09/2016
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