Healthcare Provider Details

I. General information

NPI: 1518973312
Provider Name (Legal Business Name): OSCAR A. PABON RODRIGUEZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 1 A 36 MARGINAL 167 URB. MAGNOLIA GARDENS
BAYAMON PR
00956
US

IV. Provider business mailing address

PO BOX 607071 PRM 77
BAYAMON PR
00960-7071
US

V. Phone/Fax

Practice location:
  • Phone: 787-779-1681
  • Fax: 787-995-3761
Mailing address:
  • Phone: 787-779-1681
  • Fax: 787-995-3761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. OSCAR A PABON
Title or Position: PRESIDENT
Credential:
Phone: 787-779-1681