Provider Demographics
NPI:1336312982
Name:PABLO J ACEBAL MD PA
Entity Type:Organization
Organization Name:PABLO J ACEBAL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROSURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:J
Authorized Official - Last Name:ACEBAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:305-273-3355
Mailing Address - Street 1:16471 SW 75TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3754
Mailing Address - Country:US
Mailing Address - Phone:305-273-3355
Mailing Address - Fax:305-273-8044
Practice Address - Street 1:11760 BIRD RD
Practice Address - Street 2:606
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3582
Practice Address - Country:US
Practice Address - Phone:305-273-3355
Practice Address - Fax:305-273-8044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 69051305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL28449Medicare PIN