Ponce Advance Medical Group Network, Corp.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PONCE ADVANCE MEDICAL GROUP NETWORK, CORP.

Practice address

PMB 282
1575 Munoz Rivera Ave.
Ponce, PR 00717

Phone

(787) 813-2325

Fax

(787) 841-3908

NPI assigned

Jul 22, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Luis M Irizarry Pabon, MD

Title

President

Phone

(787) 813-2325

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311292800000",
    "number": "1023396231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1266 AVE HOSTOS",
            "address_2": "ESQUINA POWER",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007170947",
            "telephone_number": "787-813-2325",
            "fax_number": "787-841-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PMB 282",
            "address_2": "1575 MUNOZ RIVERA AVE.",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00717",
            "telephone_number": "787-813-2325",
            "fax_number": "787-841-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONCE ADVANCE MEDICAL GROUP NETWORK, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-22",
        "last_updated": "2011-07-22",
        "status": "A",
        "authorized_official_last_name": "IRIZARRY PABON",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-813-2325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Policlinicas Medicas Asociadas, Inc.
• Daniela Polonio-Mejia
• Ronald Fernando Pomacondor
• Jonathan Pomales Diaz, D.C.
• Ponce Advance Medical Group
• Ponce Advance Medical Group, LLC
• Ponce Area Medical Equipment and Supply Corp
• Ponce Cardiology Group, P. S. C.
• Ponce Cardiovascular Services, PSC
• Ponce Clinical Laboratory, Inc.

• All providers in Ponce, PR
• Primary Care Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.