Organization
PONCE MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL S GJELOSHI (PRESIDENT)
(786) 502-4620
Entity
Organization
Contact information
Practice address
5068 NW 74 AVE, MIAMI, FL 33166
(786) 502-4620
(786) 502-4628
Mailing address
5068 NW 74 AVE, MIAMI, FL 33166
(786) 502-4620
(786) 502-4628
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
06/19/2014
Last updated
06/19/2014
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