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General NPI Number Information
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NPI Number | 1245162387
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Entity Type | Organization
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Legal Business Name | PONCE DENTAL OF CORAL GABLES CORP
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Dates
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Enumeration Date | 06/02/2026
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Last Update Date | 06/02/2026
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Provider Practice Location Address
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Address Line | 3190 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33134-6826
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Country | US
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Telephone | 305-774-7273
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Fax | 321-400-1370
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Provider Business Mailing Address
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Address Line | 535 W 55TH PL
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City | HIALEAH
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State | FL
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Zip | 33012-2554
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Country | US
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Telephone | 305-774-7273
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Fax | 321-400-1370
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Authorized Official
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Title or Position | DENTIST
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Name | MALENA LEMUS RAMOS
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Credential | DMD
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Telephone | 786-614-6145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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