Provider Demographics
NPI:1093368045
Name:PONCE, ALEESA JUNEL (APRN, CNM)
Entity Type:Individual
Prefix:
First Name:ALEESA
Middle Name:JUNEL
Last Name:PONCE
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:ALEESA
Other - Middle Name:JUNEL
Other - Last Name:TOMLINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4932 W STATE ROAD 46
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-9242
Mailing Address - Country:US
Mailing Address - Phone:407-635-3340
Mailing Address - Fax:407-636-7847
Practice Address - Street 1:4932 W STATE ROAD 46
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-9242
Practice Address - Country:US
Practice Address - Phone:407-635-3340
Practice Address - Fax:407-636-7847
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003321367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife