Organization
PONCE SERVICES CORPORATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUZ MARY SABOGAL (PRESIDENT)
(305) 244-3967
Entity
Organization
Contact information
Practice address
6595 NW 36TH ST, SUITE 315, VIRGINIA GARDENS, FL 33166-6979
(305) 244-3967
Mailing address
6595 NW 36TH ST, SUITE 315, VIRGINIA GARDENS, FL 33166-6979
(305) 244-3967
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC5507
AHCA CERTIFICATE OF EXEMP
FL
Enumeration date
12/16/2006
Last updated
08/22/2020
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