Provider Demographics
NPI:1326805417
Name:PASTRANA BARIATRICS PA
Entity Type:Organization
Organization Name:PASTRANA BARIATRICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLON
Authorized Official - Middle Name:
Authorized Official - Last Name:PASTRANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-717-7537
Mailing Address - Street 1:815 N HOMESTEAD BLVD UNIT 119
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-5024
Mailing Address - Country:US
Mailing Address - Phone:305-717-7537
Mailing Address - Fax:305-400-0053
Practice Address - Street 1:975 BAPTIST WAY STE 203
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7600
Practice Address - Country:US
Practice Address - Phone:305-717-7537
Practice Address - Fax:305-400-0053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty