Provider Demographics
NPI:1598791212
Name:ACEBAL, PABLO J (MD)
Entity Type:Individual
Prefix:DR
First Name:PABLO
Middle Name:J
Last Name:ACEBAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 430885
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33243-0885
Mailing Address - Country:US
Mailing Address - Phone:305-220-2455
Mailing Address - Fax:305-220-2448
Practice Address - Street 1:10095 SW 88TH ST STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1797
Practice Address - Country:US
Practice Address - Phone:305-220-2455
Practice Address - Fax:305-220-2448
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2019-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0069051207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001247200Medicaid
FL379562400Medicaid