Provider Demographics
NPI:1508990292
Name:PABALAN AND PESTANA MDS PA
Entity Type:Organization
Organization Name:PABALAN AND PESTANA MDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:PABALAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-665-6926
Mailing Address - Street 1:6280 SUNSET DR
Mailing Address - Street 2:SUITE 611
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4827
Mailing Address - Country:US
Mailing Address - Phone:305-665-6926
Mailing Address - Fax:305-665-4670
Practice Address - Street 1:6280 SUNSET DR
Practice Address - Street 2:SUITE 611
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4827
Practice Address - Country:US
Practice Address - Phone:305-665-6926
Practice Address - Fax:305-665-4670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36804207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty