Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ponce Mediclub LLC

Organization General Practice Physician · NPI 1902468523

Ponce Mediclub LLC is a General Practice Physician in Miami, Florida. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9950 SW 107th Ave Ste 203
Miami, FL 33176-2767
Phone: (305) 908-3144
Fax: (407) 605-5129
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1902468523
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Maria Lopez — Director Of Operations Med Ctr · (305) 992-4521
NPI enumeratedJuly 3, 2019
Last updated in NPPESMay 12, 2022
Certification dateMay 10, 2022
Mailing address11455 Sw 40th St # 146, Miami, FL 33165-3311

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