Healthcare Provider Details

I. General information

NPI: 1013841758
Provider Name (Legal Business Name): WESLEE PEDROSO OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2485 E PIKES PEAK AVE
COLORADO SPRINGS CO
80909-6004
US

IV. Provider business mailing address

2485 E PIKES PEAK AVE
COLORADO SPRINGS CO
80909-6004
US

V. Phone/Fax

Practice location:
  • Phone: 719-634-2001
  • Fax:
Mailing address:
  • Phone: 719-634-2001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0004223
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: