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Individual

HAROLD PONCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC WAIVER

Contact information

Practice address
3550 BISCAYNE BLVD, MIAMI, FL 33137-3841
(305) 576-6611
(786) 476-2830
Mailing address
3601 FEDERAL HWY, MIAMI, FL 33137-3795
(305) 576-6611
(786) 476-2830

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
FL

Other

Enumeration date
11/30/2015
Last updated
11/30/2015
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