Individual
XIOMARA SAGRARIO PONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9380 SW 72ND ST, SUITE B-120, MIAMI, FL 33173-3276
(305) 274-3738
(305) 274-0841
Mailing address
750 NW 43RD AVE, #206, MIAMI, FL 33126-3559
(305) 447-8606
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2309
—
FL
Enumeration date
05/07/2007
Last updated
07/09/2007
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