Provider Demographics
NPI:1649684051
Name:PAVON OGANDO, FRANK (APRN)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:PAVON OGANDO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:FRANK
Other - Middle Name:
Other - Last Name:PAVON OGANDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:12813 SW 20TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-1315
Mailing Address - Country:US
Mailing Address - Phone:786-218-2073
Mailing Address - Fax:
Practice Address - Street 1:12813 SW 20TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-1315
Practice Address - Country:US
Practice Address - Phone:786-218-2073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9243483163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse