Healthcare Provider Details

I. General information

NPI: 1992624126
Provider Name (Legal Business Name): NATACHA PEDROSO MEDINA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD
MIAMI BEACH FL
33140-2948
US

IV. Provider business mailing address

13634 SW 72ND TER
MIAMI FL
33183-3220
US

V. Phone/Fax

Practice location:
  • Phone: 786-343-6497
  • Fax:
Mailing address:
  • Phone: 786-343-6497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11049033
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: