Provider Demographics
NPI:1235452970
Name:ALFREDO G. PUJOL, M.D., P.A.
Entity Type:Organization
Organization Name:ALFREDO G. PUJOL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:G
Authorized Official - Last Name:PUJOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-825-0701
Mailing Address - Street 1:4201 PALM AVE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4424
Mailing Address - Country:US
Mailing Address - Phone:305-825-0701
Mailing Address - Fax:305-826-0052
Practice Address - Street 1:4201 PALM AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4424
Practice Address - Country:US
Practice Address - Phone:305-825-0701
Practice Address - Fax:305-826-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00448052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL044997100Medicaid
FL02645Medicare PIN
FL044997100Medicaid
FLDD666AMedicare PIN
FL02645YMedicare PIN