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NPI Code Detail

MEDICARE: ALICIA BEATRIZ PEDRERA O.D

MEDICARE: ALICIA BEATRIZ PEDRERA O.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist6932FL

General Provider Information

NPI Number : 1578492666
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA BEATRIZ PEDRERA O.D
Provider Business Mailing Address
First Line : 3200 S UNIVERSITY DR
Second Line :
City : DAVIE
State : FL
Zip : 33328-2018
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3200 S UNIVERSITY DR
Second Line :
City : DAVIE
State : FL
Zip : 33328-2018
Country : US
Telephone Number : 305-495-2699
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2026
Last Update Date : 05/15/2026

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