Individual provider Active NPI

Mercedes Ponce de Leon, M.D

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1346500782
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME122121 Issued in FL
Practice address
330 SW 27TH Ave Ste 706
Miami, FL 33135-2968
Phone
(786) 305-4502
Fax
(305) 603-7069
NPI assigned
May 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10044658 TX
Internal Medicine Physician 207R00000X ME122121 FL Primary

Addresses

Primary practice location

330 SW 27TH Ave Ste 706
Miami, FL 33135-2968

Mailing address

330 SW 27TH Ave Ste 706
Miami, FL 33135-2968
Phone (786) 305-4502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150925001131 FL Practitioner - Internal Medicine 3577871466 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10044658TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Physicians of Country Walk LLC CurrentSince Sep 1, 2015 Accepting new patients
Urgent Care Physicians of Palmetto Bay LLC CurrentSince Sep 1, 2015 Accepting new patients
Criticare Clinics Inc CurrentSince Jun 17, 2017 Accepting new patients
Urgent Care Physicians of Tamiami LLC CurrentSince Sep 1, 2015 Accepting new patients

Locations

10 Giralda Ave
Coral Gables, FL 33134
Phone (786) 459-5000

1240 S Dixie Hwy
Coral Gables, FL 33146
Phone (305) 669-2833

4741 S University Dr
Davie, FL 33328
Phone (954) 837-1050

9915 NW 41st St
Doral, FL 33178
Phone (305) 271-8851

14660 SW 8th St
#100
Miami, FL 33184
Phone (786) 596-4100

8840 SW 40th St
Ste 100
Miami, FL 33165
Phone (786) 596-3890

2660 Brickell Ave
Miami, FL 33129
Phone (786) 467-5320

13500 SW 152nd St
Miami, FL 33177
Phone (786) 596-4300

14701 NW 77th Ave
Miami Lakes, FL 33014
Phone (305) 669-2833

8750 SW 144th St
Palmetto Bay, FL 33176
Phone (786) 596-3840

15885 Pines Blvd
Pembroke Pines, FL 33027
Phone (954) 837-1300

12472 W Sunrise Blvd
Sunrise, FL 33323
Phone (305) 297-3561

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1346500782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SW 27TH AVE STE 706",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331352968",
            "telephone_number": "786-305-4502",
            "fax_number": "305-603-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 SW 27TH AVE STE 706",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331352968",
            "telephone_number": "786-305-4502",
            "fax_number": "305-603-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE DE LEON",
        "first_name": "MERCEDES",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-19",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10044658",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME122121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.