NPIMap

Organization Active NPI

Ponce Home Medical Equipment, Inc.

  • Durable Medical Equipment & Medical Supplies
  • St Augustine, FL
National Provider Identifier
1790931871
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
1313412 Issued in FL
Legal business name
PONCE HOME MEDICAL EQUIPMENT, INC.
Practice address
1100 Plantation Island Dr S
Suite 140
St Augustine, FL 32080-6188
Phone
(904) 461-9050
Fax
(904) 461-9060
NPI assigned
Aug 8, 2008
Last updated
Sep 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Authorized official

Name
Betty Carvajal-Pantaleon, M.S.NPI 1356614960
Title
Owner
Phone
(904) 461-9050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1313412 FL Primary

Addresses

Primary practice location

1100 Plantation Island Dr S
Suite 140
St Augustine, FL 32080-6188

Mailing address

PO Box 3123
St Augustine, FL 32085-3123
Phone (904) 824-4990

Other identifiers 2

IdentifierTypeStateIssuer
000535300MedicaidFL
613159001OtherFLDOL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316131200000",
    "number": "1790931871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3123",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320853123",
            "telephone_number": "904-824-4990",
            "fax_number": "904-824-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PLANTATION ISLAND DR S",
            "address_2": "SUITE 140",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320806188",
            "telephone_number": "904-461-9050",
            "fax_number": "904-461-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONCE HOME MEDICAL EQUIPMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-08",
        "last_updated": "2011-09-16",
        "status": "A",
        "authorized_official_last_name": "CARVAJAL-PANTALEON",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-461-9050",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "1313412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000535300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "613159001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.