Healthcare Provider Details

I. General information

NPI: 1568580355
Provider Name (Legal Business Name): PONCE SCHOOL OF MEDICINE CAIMED CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 CALLE MONTERREY
PONCE PR
00716-0377
US

IV. Provider business mailing address

PO BOX 7004
PONCE PR
00732-7004
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-2505
  • Fax: 787-840-2535
Mailing address:
  • Phone: 787-840-2505
  • Fax: 787-840-2535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH A BARRANCO
Title or Position: ADMINISTRATOR
Credential: MD
Phone: 787-840-2505