Provider Demographics
NPI:1851616783
Name:URBANDT, PABLO ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:PABLO
Middle Name:ALBERTO
Last Name:URBANDT
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 1:4101 NW 4TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2850
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4101 NW 4TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2850
Practice Address - Country:US
Practice Address - Phone:954-681-4088
Practice Address - Fax:954-678-0166
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-04
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106687207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine