Provider Demographics
NPI:1578996146
Name:PABON-NADAL, CALVI ENID (MD)
Entity Type:Individual
Prefix:DR
First Name:CALVI
Middle Name:ENID
Last Name:PABON-NADAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4825 N US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-7207
Mailing Address - Country:US
Mailing Address - Phone:321-271-0170
Mailing Address - Fax:321-610-7638
Practice Address - Street 1:2575 N COURTENAY PKWY
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4126
Practice Address - Country:US
Practice Address - Phone:321-454-7165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-18
Last Update Date:2013-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5113208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice