Provider Demographics
NPI:1407901713
Name:RECINOS, PABLO FERNANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:PABLO
Middle Name:FERNANDO
Last Name:RECINOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PABLO
Other - Middle Name:FERNANDO
Other - Last Name:RECINOS-CHAVARRIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:171 BURWICK RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3821
Mailing Address - Country:US
Mailing Address - Phone:216-445-2901
Mailing Address - Fax:216-444-0924
Practice Address - Street 1:9500 EUCLID AVE # S73
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-2901
Practice Address - Fax:216-444-0924
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.120912207T00000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery