Basic Information
Provider Information
NPI: 1487961579
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MESA - PABON
FirstName: MARCEL
MiddleName: A.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 29134
Address2: CARDIOLOGIA RCM
City: SAN JUAN
State: PR
PostalCode: 009290134
CountryCode: US
TelephoneNumber: 7877540101
FaxNumber: 7877587953
Practice Location
Address1: CENTRO MEDICO DE PR BO MONACILLOS
Address2: CENTRO CARDIOVASCULAR DE PR Y EL CARIBE
City: SAN JUAN
State: PR
PostalCode: 00935
CountryCode: US
TelephoneNumber: 7877548500
FaxNumber: 7877587953
Other Information
ProviderEnumerationDate: 09/10/2010
LastUpdateDate: 11/01/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X20021PRN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0000X20021PRY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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