Provider Demographics
NPI:1265649412
Name:PABON, YAZMIN (PTA)
Entity Type:Individual
Prefix:MISS
First Name:YAZMIN
Middle Name:
Last Name:PABON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 3240
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-3240
Mailing Address - Country:US
Mailing Address - Phone:787-762-4940
Mailing Address - Fax:787-257-1234
Practice Address - Street 1:117-A1 CALLE 73B
Practice Address - Street 2:VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-4121
Practice Address - Country:US
Practice Address - Phone:787-762-4940
Practice Address - Fax:787-257-1234
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1585225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant