Provider Demographics
NPI:1265644868
Name:PONCE MEDICAL SCHOOL FOUNDATION, INC.
Entity Type:Organization
Organization Name:PONCE MEDICAL SCHOOL FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-840-2575
Mailing Address - Street 1:P.O. BOX 7004
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7004
Mailing Address - Country:US
Mailing Address - Phone:787-841-5150
Mailing Address - Fax:787-841-5150
Practice Address - Street 1:LABORATORIO DE REFERENCIA EN INMUNOLOGIA
Practice Address - Street 2:395 ZONA INDUSTRIAL REPARADA #2
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00732-2348
Practice Address - Country:US
Practice Address - Phone:787-841-5150
Practice Address - Fax:787-841-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory