Provider Demographics
NPI:1508006305
Name:PAL, MARCELO EDUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCELO
Middle Name:EDUARDO
Last Name:PAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 BRICKELL KEY DR APT 3005
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2691
Mailing Address - Country:US
Mailing Address - Phone:305-856-3243
Mailing Address - Fax:
Practice Address - Street 1:808 BRICKELL KEY DR APT 3005
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2691
Practice Address - Country:US
Practice Address - Phone:305-856-3243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235537208D00000X, 207L00000X
FLME 105655207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI50781Medicare UPIN