Ponce Mediclub LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PONCE MEDICLUB LLC

Practice address

9950 SW 107TH Ave Ste 203
Miami, FL 33176-2767

Phone

(305) 908-3144

Fax

(407) 605-5129

NPI assigned

Jul 3, 2019

Organization subpart

No

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

Authorized official

Name

Maria Lopez

Title

Director of Operations Med Ctr

Phone

(305) 992-4521

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19858/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1902468523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11455 SW 40TH ST # 146",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653311",
            "telephone_number": "305-908-3144",
            "fax_number": "407-605-5129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9950 SW 107TH AVE STE 203",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762767",
            "telephone_number": "305-908-3144",
            "fax_number": "407-605-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONCE MEDICLUB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-03",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-10",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS MED CTR",
        "authorized_official_telephone_number": "305-992-4521"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosali Ponce Guerra
• Ponce Health Group, Inc.
• Miguel Ponce Martinez
• Ponce Medical Supply Inc
• Ponce Medical Supply, Inc.
• Bruno Ponce Pavon
• Ponce Plaza Inc
• Ponce Plaza, Inc
• Ponce Rehab Operations LLC
• Elssy Yelitza Ponce Vega

• General Practice Physician in Miami, FL
• Providers in Miami, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.