Healthcare Provider Details

I. General information

NPI: 1639144918
Provider Name (Legal Business Name): PABLO J BAEZ CHAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 129 KM 8-5 BO CAMPO ALEGRE
HATILLO PR
00614
US

IV. Provider business mailing address

VILLANOVA #F1-25 CALLE C
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-817-0979
  • Fax:
Mailing address:
  • Phone: 787-274-0527
  • Fax: 787-764-7963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number11724
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number11724
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: