| NPI | 1194856641 |
|---|---|
| Former Legal Business Name | IVONNE PONCE DE LEON |
| Entity Type | Organization |
| Authorized Contact | IVONNE PONCE DE LEON Owner 787-856-1922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: PR 07-F-1910) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |