Provider Demographics
NPI:1669683751
Name:PABON, HERNAN D (MD)
Entity type:Individual
Prefix:DR
First Name:HERNAN
Middle Name:D
Last Name:PABON
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 1:9000 SW 137TH AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1435
Mailing Address - Country:US
Mailing Address - Phone:305-671-3503
Mailing Address - Fax:305-671-3505
Practice Address - Street 1:9000 SW 137TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1435
Practice Address - Country:US
Practice Address - Phone:305-671-3503
Practice Address - Fax:305-671-3505
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
FLME 99606207LP2900X
OH35.1420242084P0800X, 2084P0800X
FLME996062084P0802X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279633300Medicaid