Provider Demographics
NPI:1265640064
Name:CENTRO MEDICINA ALTERNATIVA PABLOS
Entity Type:Organization
Organization Name:CENTRO MEDICINA ALTERNATIVA PABLOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PABLOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-801-1818
Mailing Address - Street 1:AVE. GENERAL VALERO #313
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-4732
Mailing Address - Country:US
Mailing Address - Phone:787-801-1818
Mailing Address - Fax:787-801-2740
Practice Address - Street 1:AVE. GENERAL VALERO #313
Practice Address - Street 2:SUITE A
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-4732
Practice Address - Country:US
Practice Address - Phone:787-801-1818
Practice Address - Fax:787-801-2740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14536171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty