Organization
PONCE PLAZA, INC
Active
Other names
PONCE PLAZA NURSING & REHABILITATION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DESIREE SEBASTIAN-SANTIAGO NHA (ADMINISTRATOR)
(305) 545-6695
Entity
Organization
Contact information
Practice address
335 SW 12TH AVE, MIAMI, FL 33130-2011
(305) 545-6695
(305) 545-0398
Mailing address
335 SW 12TH AVE, MIAMI, FL 33130-2011
(305) 545-6695
(305) 545-0398
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
11400961
FL
Other
Enumeration date
11/08/2006
Last updated
08/22/2020
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