Provider Demographics
NPI:1386351112
Name:PONCE CARDIOLOGY GROUP, P. S. C.
Entity type:Organization
Organization Name:PONCE CARDIOLOGY GROUP, P. S. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GRISELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA, JD, CHC
Authorized Official - Phone:939-628-7884
Mailing Address - Street 1:909 AVE TITO CASTRO STE 623
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-4722
Mailing Address - Country:US
Mailing Address - Phone:787-812-0909
Mailing Address - Fax:787-812-0920
Practice Address - Street 1:909 AVE TITO CASTRO STE 623
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4722
Practice Address - Country:US
Practice Address - Phone:787-812-0909
Practice Address - Fax:787-812-0920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty