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NPI Code Detail

MEDICARE: PABLO VENDRELL

MEDICARE: PABLO VENDRELL
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
1390200000XStudent in an Organized Health Care Education/Training ProgramAZ

General Provider Information

NPI Number : 1891624268
Entity Type Code : Individual
Provider Name (Legal Business Name) : PABLO VENDRELL
Provider Business Mailing Address
First Line : 817 N 6TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-3053
Country : US
Telephone Number : 925-300-7880
Fax Number :
Provider Business Practice Location Address
First Line : 1111 E MCDOWELL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-2612
Country : US
Telephone Number : 925-300-7880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2026
Last Update Date : 05/20/2026

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Directions to “ PABLO VENDRELL ” Practice Location

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