Healthcare Provider Details

I. General information

NPI: 1093183311
Provider Name (Legal Business Name): RONALD E PACHON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2015
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1841 NE 45TH ST
FORT LAUDERDALE FL
33308-5117
US

IV. Provider business mailing address

1841 NE 45TH ST
FORT LAUDERDALE FL
33308-5117
US

V. Phone/Fax

Practice location:
  • Phone: 954-820-4200
  • Fax: 954-678-9533
Mailing address:
  • Phone: 954-678-9531
  • Fax: 954-678-9533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME128148
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME128148
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: