Provider Demographics
NPI:1851460372
Name:POND, SONEATH LANG HANG (MD)
Entity type:Individual
Prefix:
First Name:SONEATH
Middle Name:LANG HANG
Last Name:POND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:7745 GALL BLVD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-4315
Practice Address - Country:US
Practice Address - Phone:813-715-4446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI10102207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI25992-9OtherBLUE CROSS
RI9002754Medicaid
RI25992-9OtherLIFESPANBLUE
RI04-06646OtherUNITED HEALTH CARE
RI2625OtherNEIGHBORHOOD HEALTH PLAN
RI406179OtherTUFTS
RI405534OtherBLUE CHIP
RI406179OtherTUFTS