Healthcare Provider Details

I. General information

NPI: 1043208804
Provider Name (Legal Business Name): PONCE MEDICAL SCHOOL FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 08/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE ANA D PEREZ MARSHAND, LOTE 2 BY PASS ANTIGUA CLINICA DE VETERANOS URB INDUSTRIAL REPARADA
PONCE PR
00732-7004
US

IV. Provider business mailing address

PO BOX 7004
PONCE PR
00732-7004
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-0052
  • Fax: 787-840-2317
Mailing address:
  • Phone: 787-840-0052
  • Fax: 787-840-2317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RAUL ARMSTRONG
Title or Position: PRESIDENTE
Credential: MD
Phone: 787-840-0052