MEDICARE: DR. HERNAN D PABON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME 99606	FL
3	2084P0800X	Psychiatry Physician	35.142024	OH
4	2084P0802X	Addiction Psychiatry Physician	ME99606	FL
5	2084P0800X	Psychiatry Physician	ME99606	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669683751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERNAN D PABON MD

Provider Business Mailing Address
First Line	:	9000 SW 137TH AVE STE 103
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-1435
Country	:	US
Telephone Number	:	305-671-3503
Fax Number	:	305-671-3505

Provider Business Practice Location Address
First Line	:	9000 SW 137TH AVE STE 103
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-1435
Country	:	US
Telephone Number	:	305-671-3503
Fax Number	:	305-671-3505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	05/06/2024

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Directions to “ DR. HERNAN D PABON MD” Practice Location

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