Provider Demographics
NPI:1306370143
Name:POINCIANA BILLING SERVIES
Entity Type:Organization
Organization Name:POINCIANA BILLING SERVIES
Other - Org Name:POINCIANA BILLING COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:L
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:AB
Authorized Official - Phone:407-738-0586
Mailing Address - Street 1:PO BOX 452848
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34745-2848
Mailing Address - Country:US
Mailing Address - Phone:407-738-0586
Mailing Address - Fax:
Practice Address - Street 1:105 E MONUMENT AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5761
Practice Address - Country:US
Practice Address - Phone:407-738-0586
Practice Address - Fax:321-250-7463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-19
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/CoderGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010845700Medicaid