| Gloria Ponce Tua Medicina Interna Csp | |
|
Calle Dr Basora No 55n Suite 204d Mayaguez PR 00680-4888 | |
| (787) 833-0685 | |
| (787) 265-2755 |
| Full Name | Gloria Ponce Tua Medicina Interna Csp |
|---|---|
| Speciality | Internal Medicine |
| Location | Calle Dr Basora No 55n, Mayaguez, Puerto Rico |
| Authorized Official Name and Position | Gloria I Ponce Tua (MEDICO INTERNISTA) |
| Authorized Official Contact | 7878330685 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gloria Ponce Tua Medicina Interna Csp Calle Dr Basora No 55n Suite 204d Mayaguez PR 00680-4888 Ph: (787) 833-0685 | Gloria Ponce Tua Medicina Interna Csp Calle Dr Basora No 55n Suite 204d Mayaguez PR 00680-4888 Ph: (787) 833-0685 |
| NPI Number | 1184048175 |
|---|---|
| Provider Enumeration Date | 02/11/2014 |
| Last Update Date | 08/04/2014 |
| Medicare PECOS PAC ID | 8426276379 |
|---|---|
| Medicare Enrollment ID | O20140905002089 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184048175 | NPI | - | NPPES |
| 1336189315 | Other | PR | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 13516 (Puerto Rico) | Primary |
| Provider Name | Gloria I Ponce |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336189315 PECOS PAC ID: 7113939620 Enrollment ID: I20060628000074 |
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