Provider Demographics
NPI:1255909032
Name:COMPANIONI DELGADO, PABLO SR (DMD)
Entity type:Individual
Prefix:DR
First Name:PABLO
Middle Name:
Last Name:COMPANIONI DELGADO
Suffix:SR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9575 SW 145TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1098
Mailing Address - Country:US
Mailing Address - Phone:786-856-9629
Mailing Address - Fax:
Practice Address - Street 1:30 NW 15TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4262
Practice Address - Country:US
Practice Address - Phone:305-245-9691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25952122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist