Provider Demographics
NPI:1679653182
Name:DIAZ-BORDON, PEDRO PABLO (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:PABLO
Last Name:DIAZ-BORDON
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 1:3407 PHILS LN
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-5409
Mailing Address - Country:US
Mailing Address - Phone:407-325-2032
Mailing Address - Fax:407-770-1792
Practice Address - Street 1:2886 S OSCEOLA AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-5431
Practice Address - Country:US
Practice Address - Phone:407-325-2032
Practice Address - Fax:407-770-1792
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 26065207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology