Provider Demographics
NPI:1780629261
Name:PABALAN, RAMON J (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:J
Last Name:PABALAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14050 NW 14TH ST
Mailing Address - Street 2:SUITE 190
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2865
Mailing Address - Country:US
Mailing Address - Phone:800-424-3672
Mailing Address - Fax:954-377-3042
Practice Address - Street 1:636 DEL PRADO BLVD S
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2668
Practice Address - Country:US
Practice Address - Phone:239-772-6513
Practice Address - Fax:239-574-0269
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2008-04-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME40952207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15841OtherBCBS
FL4049316OtherAETNA
FL15841GMedicare ID - Type Unspecified
FL15841OtherBCBS
FLD52754Medicare UPIN