Healthcare Provider Details

I. General information

NPI: 1255909032
Provider Name (Legal Business Name): PABLO COMPANIONI DELGADO SR. DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 BILTMORE WAY STE 110
CORAL GABLES FL
33134-5724
US

IV. Provider business mailing address

2176 SW 122ND CT
MIAMI FL
33175-7312
US

V. Phone/Fax

Practice location:
  • Phone: 305-446-1047
  • Fax:
Mailing address:
  • Phone: 786-856-9629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number25952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: