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General NPI Number Information
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NPI Number | 1972258416
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Entity Type | Organization
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Legal Business Name | PONSOL NORTH MIAMI BEACH, LLC
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 1400 NE MIAMI GARDENS DR STE 105
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179-4843
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Country | US
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Telephone | 786-610-3730
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Fax | 786-610-3919
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Provider Business Mailing Address
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Address Line | 7801 SW 125TH ST
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City | PINECREST
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State | FL
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Zip | 33156-6058
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETER JOSEPH
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Credential |
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Telephone | 786-610-3730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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