Healthcare Provider Details

I. General information

NPI: 1538378880
Provider Name (Legal Business Name): NORBERTO JESUS PEDROSO MONTESINO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: NORBERTO PEDROSO M.D.

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1565 W 29TH ST
HIALEAH FL
33012-5516
US

IV. Provider business mailing address

9000 NW 15TH ST UNIT 6
DORAL FL
33172-2990
US

V. Phone/Fax

Practice location:
  • Phone: 305-537-4110
  • Fax: 305-675-2860
Mailing address:
  • Phone: 786-894-6358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME 100918
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: