Healthcare Provider Details

I. General information

NPI: 1508844192
Provider Name (Legal Business Name): NORBERTO PELLOT M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: NORBERTO PELLOT M.D.

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 05/19/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GALLARDO TOWERS SUITE 206 CARRETERA # 2
BAYAMON PR
00960
US

IV. Provider business mailing address

URB VALPARAISO CALLE 9 E-7 LEVITTOWN
TOA BAJA PR
00949-4038
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-8090
  • Fax: 787-786-5216
Mailing address:
  • Phone: 787-740-8090
  • Fax: 787-786-5216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number6308
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: