Healthcare Provider Details

I. General information

NPI: 1427677319
Provider Name (Legal Business Name): PASSQUAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2020
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18706 NW 67TH AVE
MIAMI GARDENS FL
33015-2408
US

IV. Provider business mailing address

18706 NW 67TH AVE
MIAMI GARDENS FL
33015-2408
US

V. Phone/Fax

Practice location:
  • Phone: 786-677-9922
  • Fax: 844-895-3066
Mailing address:
  • Phone: 786-677-9922
  • Fax: 844-895-3066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HENDRY JULIAN PEREZ PASCUAL
Title or Position: CEO
Credential: MD
Phone: 786-677-9922