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General NPI Number Information
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NPI Number | 1528040763
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Entity Type | Individual
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Provider Name | YAIDI PABLOS MD
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Gender | Female
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 716 AVE PONCE DE LEON OFICINA 205
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City | SAN JUAN
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State | PR
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Zip | 00918-4503
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Country | US
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Telephone | 787-764-6870
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Fax | 787-764-6870
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Provider Business Mailing Address
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Address Line | 9546 CALLE DIAZ WAY APT 910
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City | CAROLINA
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State | PR
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Zip | 00979-1410
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Country | US
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Telephone | 787-392-9311
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5353
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License Number State | PR
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