Provider Demographics
NPI:1265524607
Name:BADILLO-ABASOLO, PEDRO R (MD)
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:R
Last Name:BADILLO-ABASOLO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:URB CIUDAD JARDIN DE CANOVANAS
Mailing Address - Street 2:CALLE CEIBA #11
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-769-7525
Mailing Address - Fax:787-769-2428
Practice Address - Street 1:AVE EL COMANDANTE CALLE 266 PB30
Practice Address - Street 2:3ERA EXT COUNTRY CLUB
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982
Practice Address - Country:US
Practice Address - Phone:787-769-7525
Practice Address - Fax:787-769-2428
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2024-10-16
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Provider Licenses
StateLicense IDTaxonomies
PR14589208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI-25561Medicare UPIN