Provider Demographics
NPI:1205855228
Name:POLICLINICAS DE PONCE
Entity Type:Organization
Organization Name:POLICLINICAS DE PONCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADOR MEDICO
Authorized Official - Prefix:DR
Authorized Official - First Name:EFRAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ DROZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-812-3193
Mailing Address - Street 1:PMB 261 PO BOX 7105
Mailing Address - Street 2:MORREL CAMPOS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7105
Mailing Address - Country:US
Mailing Address - Phone:787-812-3153
Mailing Address - Fax:787-290-6689
Practice Address - Street 1:PLAZOLETA PONCE CASH & CARRY LOCAL 4 MORELL CAMPOS
Practice Address - Street 2:MORREL CAMPOS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00732-7105
Practice Address - Country:US
Practice Address - Phone:787-812-3153
Practice Address - Fax:787-290-6689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty