Healthcare Provider Details

I. General information

NPI: 1982247037
Provider Name (Legal Business Name): PNS CLINICAL STAFFING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2019
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8323 NW 12TH ST
DORAL FL
33126-1829
US

IV. Provider business mailing address

8323 NW 12TH ST
DORAL FL
33126-1829
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-7484
  • Fax: 305-901-5480
Mailing address:
  • Phone: 305-284-7484
  • Fax: 305-901-5480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE A. PELAYO
Title or Position: MANAGING MEMBER
Credential: DC
Phone: 305-284-7484