Provider Demographics
NPI:1518973312
Name:OSCAR A. PABON RODRIGUEZ
Entity type:Organization
Organization Name:OSCAR A. PABON RODRIGUEZ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:PABON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-779-1681
Mailing Address - Street 1:PO BOX 607071
Mailing Address - Street 2:PRM 77
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-7071
Mailing Address - Country:US
Mailing Address - Phone:787-779-1681
Mailing Address - Fax:787-995-3761
Practice Address - Street 1:CALLE 1 A 36 MARGINAL 167
Practice Address - Street 2:URB. MAGNOLIA GARDENS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-779-1681
Practice Address - Fax:787-995-3761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4453440001Medicare NSC