Individual
CARMEN PONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7224 JAFFERY CT, ORLANDO, FL 32835-6158
(407) 822-5330
Mailing address
7224 JAFFERY CT, ORLANDO, FL 32835-6158
(407) 822-5330
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6905794
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142415700
—
FL
Enumeration date
05/21/2007
Last updated
07/24/2011
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