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Individual

DR. PABLO MARTIN PELLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6817 SOUTHPOINT PKWY STE 801, JACKSONVILLE, FL 32216-6292
(904) 646-3420
(904) 646-3017
Mailing address
8773 PERIMETER PARK CT, JACKSONVILLE, FL 32216-1165
(904) 493-3390
(904) 493-3395

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME64398
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0111508-00
MEDICAID - GROUP
FL
01
219953
AVMED
FL
05
250465100
FL
01
25066
WELLCARE
FL
01
74509
FLORIDA BLUE - GROUP
FL
01
K2410
MEDICARE - GROUP
FL
Enumeration date
08/25/2006
Last updated
04/26/2024
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