Healthcare Provider Details

I. General information

NPI: 1568802304
Provider Name (Legal Business Name): JESSICA MICHELLE PASTORIZA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 ALTON ROAD
MIAMI BEACH FL
33140-2840
US

IV. Provider business mailing address

4306 ALTON RD FL 2
MIAMI BEACH FL
33140-2840
US

V. Phone/Fax

Practice location:
  • Phone: 305-674-2397
  • Fax: 305-674-2863
Mailing address:
  • Phone: 305-674-2397
  • Fax: 305-674-2863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberME166033
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number281339-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: