Provider Demographics
NPI:1952752354
Name:PONCE, FELIZARDO
Entity type:Individual
Prefix:
First Name:FELIZARDO
Middle Name:
Last Name:PONCE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14335 SW 120TH ST
Mailing Address - Street 2:201
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7294
Mailing Address - Country:US
Mailing Address - Phone:305-967-8074
Mailing Address - Fax:305-967-8302
Practice Address - Street 1:2468 SW 137TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6330
Practice Address - Country:US
Practice Address - Phone:786-832-6630
Practice Address - Fax:786-558-5229
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst