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General NPI Number Information
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NPI Number | 1063297182
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Entity Type | Organization
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Legal Business Name | PABON DERMATOLOGY, LLC
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 735 AVE PONCE DE LEON STE 415
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City | SAN JUAN
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State | PR
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Zip | 00917-5026
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Country | US
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Telephone | 787-763-9813
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 192382
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City | SAN JUAN
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State | PR
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Zip | 00919
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Country | US
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Telephone | 787-415-1545
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Fax |
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Authorized Official
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Title or Position | CEO/ MANAGER
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Name | GABRIELA PABON
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Credential | MD
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Telephone | 787-415-1545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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