Individual provider Active NPI

Priscilla Dulce Pabon, PA-C

  • Medical Physician Assistant
  • Miami Lakes, FL
National Provider Identifier
1114457579
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9118087 Issued in FL
Practice address
16250 NW 57TH Ave
Miami Lakes, FL 33014
Phone
(786) 442-2136
NPI assigned
Jun 18, 2017
Reactivated
Dec 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9118087 FL Primary

Addresses

Primary practice location

16250 NW 57TH Ave
Miami Lakes, FL 33014

Mailing address

8001 SW 36TH St Ste 9
Davie, FL 33328-1915
Phone (954) 577-7790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9118087FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saltzman, Tanis, Pittel, Levin and Jacobson, LLC Single Specialty CurrentSince Dec 24, 2023 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Single Specialty PastSince Dec 24, 2023 Accepting new patients

Locations

16250 NW 57th Ave
Miami Lakes, FL 33014
Phone (786) 442-2136

900 S Pine Island Rd
Ste 800
Plantation, FL 33324
Phone (954) 967-6400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1114457579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 SW 36TH ST STE 9",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333281915",
            "telephone_number": "954-577-7790",
            "fax_number": "954-577-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16250 NW 57TH AVE",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "33014",
            "telephone_number": "786-442-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABON",
        "first_name": "PRISCILLA",
        "middle_name": "DULCE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "deactivation_date": "2023-11-13",
        "reactivation_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9118087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.