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General NPI Number Information
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NPI Number | 1265468805
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Entity Type | Organization
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Legal Business Name | PONCE GASTROENTEROLOGY SOCIETY
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | SANTA MARIA MEDICAL 450 C/FERROCARRIL, STE. 210
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City | PONCE
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State | PR
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Zip | 00717-1105
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Country | US
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Telephone | 787-840-0100
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Fax | 787-841-6849
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Provider Business Mailing Address
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Address Line | 450 FERROCARRIL STA. MARIA MEDICAL STE. 210
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City | PONCE
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State | PR
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Zip | 00717-1105
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Country | US
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Telephone | 787-840-0100
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Fax | 787-841-6849
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LUIS MARTINEZ-SIERRA
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Credential | MD
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Telephone | 787-840-5042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 4589
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 6905
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 7296
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License Number State | PR
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