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General NPI Number Information
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NPI Number | 1508990292
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Entity Type | Organization
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Legal Business Name | PABALAN AND PESTANA MDS PA
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 6280 SUNSET DR SUITE 611
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4827
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Country | US
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Telephone | 305-665-6926
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Fax | 305-665-4670
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Provider Business Mailing Address
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Address Line | 6280 SUNSET DR SUITE 611
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4827
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Country | US
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Telephone | 305-665-6926
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Fax | 305-665-4670
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN S PABALAN
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Credential | M.D.
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Telephone | 305-665-6926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME36804
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License Number State | FL
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