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General NPI Number Information
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NPI Number | 1215390711
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Entity Type | Individual
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Provider Name | YOEL OLAZABAL PUPO M.D
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Gender | Male
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Dates
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Enumeration Date | 04/01/2016
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 12402 S ORANGE BLOSSOM TRL STE 6
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City | ORLANDO
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State | FL
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Zip | 32837-6539
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Country | US
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Telephone | 407-541-0114
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Fax | 855-592-1942
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Provider Business Mailing Address
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Address Line | 6101 BLUE LAGOON DR STE 200
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City | MIAMI
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State | FL
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Zip | 33126-3168
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Country | US
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Telephone | 305-500-2000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME158724
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A164723
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License Number State | CA
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