MEDICARE: PEDRO MONSERRATE M.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
1	174400000X	Specialist	ME0063174	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0599674	OTHER	FL	GHI PPO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	3911740004	OTHER	FL	CIGNA HMO
4	18915	OTHER	FL	BCBS
5	592207264	OTHER	FL	CIGNA PPO
6	592207264E	OTHER	FL	HUMANA
7	4374392	OTHER	FL	AETNA PPO
8	0905525	OTHER	FL	UHC
9	0664623	OTHER	FL	AETNA HMO

General Provider Information

NPI Number	:	1932142064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEDRO MONSERRATE M.D.

Provider Business Mailing Address
First Line	:	3210 CLEVELAND AVE STE 100
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-7182
Country	:	US
Telephone Number	:	239-574-0011
Fax Number	:	239-574-4020

Provider Business Practice Location Address
First Line	:	2721 DEL PRADO BLVD S
Second Line	:	SUITE 260
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-5781
Country	:	US
Telephone Number	:	239-574-0011
Fax Number	:	239-574-4020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	03/05/2014

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Directions to “ PEDRO MONSERRATE M.D.” Practice Location

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