MEDICARE: CARLOS M PABLOS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME0059290	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326036716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS M PABLOS M.D.

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 400
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-2051
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5801 MIAMI LAKES DR E
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-2401
Country	:	US
Telephone Number	:	305-821-9115
Fax Number	:	305-821-9150

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	11/30/2021

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Directions to “ CARLOS M PABLOS M.D.” Practice Location

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