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General NPI Number Information
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NPI Number | 1578236758
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Entity Type | Organization
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Legal Business Name | PONCE HYPERBARIC AND WOUND CARE,CP
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Dates
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Enumeration Date | 07/26/2021
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 2435 BLVD LUIS A FERRE
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City | PONCE
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State | PR
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Zip | 00717-2112
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Country | US
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Telephone | 787-709-4090
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Fax |
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Provider Business Mailing Address
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Address Line | JARDINES DE PONCE C26 CALLE POLYANTHA
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City | PONCE
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State | PR
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Zip | 00730
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Country | US
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Telephone | 787-630-3725
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RENIER DAVID GONZALEZ
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Credential | MD
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Telephone | 787-651-5577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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