Provider Demographics
NPI:1598025900
Name:PONCE MEDICAL SCHOOL FOUNDATION INC.
Entity Type:Organization
Organization Name:PONCE MEDICAL SCHOOL FOUNDATION INC.
Other - Org Name:ESCUELA DE MEDICINA DE PONCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND DEAN
Authorized Official - Prefix:DR
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ DE ARZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-840-2575
Mailing Address - Street 1:PO 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:787-840-2575
Mailing Address - Fax:787-284-2395
Practice Address - Street 1:637 SUR AVE. SANTA TERESA DE HORNET
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00681
Practice Address - Country:US
Practice Address - Phone:787-834-8800
Practice Address - Fax:787-832-0305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty