DR. KELLY A PONCHERI (NPI# 1689823742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689823742 |
| Entity Type | Individual |
| Full Name | DR. KELLY A PONCHERI |
| Credential | DPM |
| Practice Address |
4712 Exploration Ave Lakeland FL 33812-3319 |
| Mailing Address |
5050 S Florida Ave Lakeland FL 33813-2501 |
| Practice Telephone | 8636441313 |
| Mailing Telephone | 8636441313 |
| Mailing Fax Number | 2392781159 |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2016-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
SC006075 | PA | Podiatric Medicine & Surgery Service Providers |
| Street Address |
4712 EXPLORATION AVE |
| City | LAKELAND |
| State | FL |
| Zip Code | 33812-3319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104956218 | Elizabeth J. Palazzi-xirinachs | Nurse Practitioner | 4712 Exploration Ave, Lakeland, FL 33812-3319 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891036976 | Arlene Nitza Hunt | Counselor | 5421 Us Highway 98 S, Lakeland, FL 33812 | 2013-03-14 |
| 1952648867 | Christopher Benka | Pharmacist | 5185 Us Highway 98 S, Lakeland, FL 33812 | 2013-01-11 |
| 1407105083 | Elena Kan | Dentist | 5644 Vintage View Boulevard, Lakeland, FL 33812 | 2012-08-29 |
| 1760611412 | Blanca Lilia Fernandez | Dentist | 5163 Us Highway 98 S, Lakeland, FL 33812 | 2009-07-02 |
| 1033314190 | Gustavo Alberto De Jesus-gomez | Surgery | 5907 Hillside Heights Dr., Lakeland, FL 33812 | 2007-06-19 |
| 1760600142 | Internal Medicine Specialists Medical Group Pa | Internal Medicine | 3655 Innovation Dr, Lakeland, FL 33812 | 2007-04-23 |
| 1124171475 | Sports and Orthopedic Rehabilitation Services Inc | Clinic/Center | 5155 Us Highway 98 South, Suites 5b&5c, Lakeland, FL 33812 | 2007-01-19 |
| 1356322234 | Carlos M Romero | Family Medicine | 3655 Innovation Drive, Lakeland, FL 33812 | 2005-11-08 |
| 1427055318 | Roxann Castelli Cook | Family Medicine | 2803 Meridian Point Lane, Lakeland, FL 33812 | 2005-07-07 |
| 1316577513 | Ashley Joanne Reckord | Counselor | 5421 Us Highway 98 S, Lakeland, FL 33812 | 2020-01-16 |
| Find all providers in zip 33812 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003884917 | William S Wong | Podiatrist | 927 S Florida Ave, Lakeland, FL 33803-1149 | 2006-03-08 |
| 1992776975 | Gabriel Felix Delgado | Podiatrist | 203 Kerneywood St, Lakeland, FL 33803-2947 | 2006-01-30 |
| 1619269362 | Kelly A. Poncheri Dpm Pa | Podiatrist | 4692 Exploration Ave, Lakeland, FL 33812-4107 | 2011-05-12 |
| 1134438948 | James Pruchniewski Dpm Pa | Podiatrist | 4973 Us Highway 98 N, Lakeland, FL 33809-3657 | 2010-09-28 |
| 1801067194 | Gabriel F Delgado Dpm Pa | Podiatrist | 203 Kerneywood St, Lakeland, FL 33803-2947 | 2008-03-14 |
| 1861662546 | Eric J. Breuggeman Dpm, Pa | Podiatrist | 1443 Lakeland Hills Blvd, Lakeland, FL 33805-3206 | 2008-03-10 |
| 1528241304 | William S Wong, D.p.m. P.a. | Podiatrist | 927 S Florida Ave, Lakeland, FL 33803-1149 | 2007-12-14 |
| 1598878191 | David W Gergen | Podiatrist | 5421 S Florida Ave, Lakeland, FL 33813-2523 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693120 | Mozhgan Alijani, Dpm, Pa | Podiatrist | 20515 E Country Club Dr Apt 544, Miami, FL 33180-3442 | 2020-09-11 |
| 1730790551 | Sacred Heart Hospital of Pensacola | Podiatrist | 1890 Summit Blvd, Pensacola, FL 32503 | 2020-08-14 |
| 1306457841 | Asdj LLC | Podiatrist | 2190 Bridgeport Cir, Rockledge, FL 32955-4338 | 2020-08-10 |
| 1316557762 | Upperline Healthcare, PC | Podiatrist | 2111 Glenwood Dr Ste 104, Winter Park, FL 32792-3328 | 2020-07-31 |
| 1790395135 | Upperline Healthcare, PC | Podiatrist | 339 Cypress Pkwy Ste 240, Kissimmee, FL 34759-3315 | 2020-07-31 |
| 1952911398 | Upperline Healthcare, PC | Podiatrist | 250 N Alafaya Trl Ste 115, Orlando, FL 32828-4336 | 2020-07-31 |
| 1639789076 | Upperline Healthcare, PC | Podiatrist | 650 S Courtenay Pkwy Ste 200, Merritt Island, FL 32952-4977 | 2020-07-31 |
| 1972113314 | Upperline Healthcare, PC | Podiatrist | 8000 Red Bug Lake Rd Ste 230, Oviedo, FL 32765-9265 | 2020-07-31 |
| 1356950646 | Palm Beach Foot & Ankle Inc | Podiatrist | 8130 Royal Palm Blvd Ste 205, Coral Springs, FL 33065-5703 | 2020-07-23 |
| 1720601891 | Yohandy Fuentes Dpm Pa | Podiatrist | 5200 Sw 8th St Ste 201a, Coral Gables, FL 33134-2337 | 2020-05-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.