Provider Demographics
NPI:1104920305
Name:PABON PADILLA, HIRAM (MD)
Entity type:Individual
Prefix:
First Name:HIRAM
Middle Name:
Last Name:PABON PADILLA
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 1:33 CALLE MUNOZ RIVERA
Mailing Address - Street 2:URB. MADRID
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-3116
Mailing Address - Country:US
Mailing Address - Phone:787-713-6801
Mailing Address - Fax:787-734-4129
Practice Address - Street 1:33 CALLE MUNOZ RIVERA
Practice Address - Street 2:URB. MADRID
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-3116
Practice Address - Country:US
Practice Address - Phone:787-713-6801
Practice Address - Fax:787-734-4129
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16514174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist