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General NPI Number Information
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NPI Number | 1104882257
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Entity Type | Organization
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Legal Business Name | RUBE J PARDO MD PHD PA
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 1828 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33134
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Country | US
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Telephone | 305-448-5795
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Fax | 305-444-6081
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Provider Business Mailing Address
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Address Line | PO BOX 144117
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City | CORAL GABLES
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State | FL
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Zip | 33114-4117
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Country | US
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Telephone | 305-448-5795
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Fax | 305-444-6081
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. RUBE J PARDO
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Credential | MD PHD
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Telephone | 305-448-5795
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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 | ME 54683
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License Number State | FL
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