Basic Information
| Provider Information | |||||||||
| NPI: | 1205356946 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PABON RODRIGUEZ | ||||||||
| FirstName: | ALEJANDRO | ||||||||
| MiddleName: | ANDRE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER | ||||||||
| Address2: | 301 MEMORIAL MEDICAL PARKWAY | ||||||||
| City: | DAYTONA BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872449411 | ||||||||
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| Practice Location | |||||||||
| Address1: | FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER | ||||||||
| Address2: | 301 MEMORIAL MEDICAL PARKWAY | ||||||||
| City: | DAYTONA BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872449411 | ||||||||
| FaxNumber: | 3862315962 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2017 | ||||||||
| LastUpdateDate: | 11/05/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 9486512 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.