Provider Demographics
NPI:1922061159
Name:VICTOR PAZOS MD PA
Entity Type:Organization
Organization Name:VICTOR PAZOS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:PAZOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-835-0551
Mailing Address - Street 1:7100 W 20TH AVE
Mailing Address - Street 2:SUITE G166
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1897
Mailing Address - Country:US
Mailing Address - Phone:305-835-0551
Mailing Address - Fax:305-696-7704
Practice Address - Street 1:7100 W 20TH AVE
Practice Address - Street 2:SUITE G166
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1897
Practice Address - Country:US
Practice Address - Phone:305-835-0551
Practice Address - Fax:305-696-7704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81933174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID NUMBER
FLH43932Medicare UPIN
FLAG100Medicare PIN