Pablo M Pella, M.D., P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0064398 Issued in FL

Legal business name

PABLO M PELLA, M.D., P.A.

Practice address

11555 Central Pkwy Ste 201
Jacksonville, FL 32224-2693

Phone

(904) 646-3420

Fax

(904) 646-3017

NPI assigned

Sep 25, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Wendy C. Lu

Title

Credentialing Coordinator

Phone

(904) 221-2535

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kayela Faye Borisade, ARNP

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1104160217
  Medicare reassignment NPD
• Pablo Martin Pella, MD

  • Infectious Disease Physician
  • Jacksonville, FL
  • NPI 1245347004
  Medicare reassignment NPD
• Ashley L Horn, ARNP

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1346565215
  Medicare reassignment
• Nicholas R Wellington, PA-C

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1194252825
  Medicare reassignment
• Hernan Robert Chang, M.D.

  • Infectious Disease Physician
  • Jacksonville, FL
  • NPI 1891720629
  NPD (past)
• Mihaela Ionescu, MD

  • Specialist
  • Orange Park, FL
  • NPI 1598734154
  NPD (past)

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393545600000",
    "number": "1447447339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11555 CENTRAL PKWY STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242693",
            "telephone_number": "904-646-3420",
            "fax_number": "904-646-3017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 CENTRAL PKWY STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242693",
            "telephone_number": "904-646-3420",
            "fax_number": "904-646-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PABLO M PELLA, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2014-02-28",
        "status": "A",
        "authorized_official_last_name": "LU",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "904-221-2535",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0064398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eduardo R Paat Sr., LMFT
• Mark Paauw, MD
• Jonathan L Pabalate, CRNA
• Pace Center for Girls
• Pace Partners of Northeast Florida, Inc.
• Georgia Pace
• Heather Leigh Pace, MS, RDN
• Megan Pace

• Specialist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.