Provider Demographics
NPI:1720335011
Name:PABLO A. URBANDT M.D. LLC
Entity Type:Organization
Organization Name:PABLO A. URBANDT M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:A
Authorized Official - Last Name:URBANDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-229-7305
Mailing Address - Street 1:9025 SW 150TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1351
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9025 SW 150TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1351
Practice Address - Country:US
Practice Address - Phone:786-229-7305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106687207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty