Provider Demographics
NPI:1740059625
Name:POND, BIANCA (AP, LAC)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:POND
Suffix:
Gender:F
Credentials:AP, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CONGRESS PARK DR STE 202
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4688
Mailing Address - Country:US
Mailing Address - Phone:561-865-5485
Mailing Address - Fax:
Practice Address - Street 1:200 CONGRESS PARK DR STE 202
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4688
Practice Address - Country:US
Practice Address - Phone:561-865-5485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-20
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4532171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist