Provider Demographics
NPI:1770666794
Name:HECTOR POMBO M.D. PA
Entity Type:Organization
Organization Name:HECTOR POMBO M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:POMBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-702-1333
Mailing Address - Street 1:7150 W 20TH AVE STE 313
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5532
Mailing Address - Country:US
Mailing Address - Phone:305-702-9313
Mailing Address - Fax:305-702-9325
Practice Address - Street 1:7150 W 20TH AVE STE 313
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5532
Practice Address - Country:US
Practice Address - Phone:305-702-9313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0070714174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1770597064OtherNPI #
FLG-36957Medicare UPIN
FL31564AMedicare ID - Type Unspecified