Provider Demographics
NPI:1437323219
Name:PANDO, JORGE (MD FACOG)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:
Last Name:PANDO
Suffix:
Gender:M
Credentials:MD FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8145 NW 155TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5872
Mailing Address - Country:US
Mailing Address - Phone:305-698-5300
Mailing Address - Fax:305-698-5302
Practice Address - Street 1:8145 NW 155TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5872
Practice Address - Country:US
Practice Address - Phone:305-698-5300
Practice Address - Fax:305-698-5302
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000165000Medicaid
FL000165000Medicaid