Provider Demographics
NPI:1083497192
Name:PAZOS CHAVEZ, OSCAR (SRNA)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:PAZOS CHAVEZ
Suffix:
Gender:M
Credentials:SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4307
Mailing Address - Country:US
Mailing Address - Phone:305-570-7428
Mailing Address - Fax:
Practice Address - Street 1:211 W 34TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4307
Practice Address - Country:US
Practice Address - Phone:305-570-7428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9532138208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice