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Individual

ERIC O PANTALEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3107 W HALLANDALE BEACH BLVD STE 102, HALLANDALE, FL 33009-5144
(786) 638-4747
(954) 367-3763
Mailing address
3107 W HALLANDALE BEACH BLVD STE 102, HALLANDALE, FL 33009-5144
(786) 638-4747
(954) 367-3763

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME006389
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1518997964
NPI
FL
01
ME0063889
STATE MEDICAL LICENSE
FL
Enumeration date
07/03/2006
Last updated
06/22/2022
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