Healthcare Provider Details

I. General information

NPI: 1366363145
Provider Name (Legal Business Name): PATRICIA PEDROSO LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5805 BLUE LAGOON DR STE 440
MIAMI FL
33126-2032
US

IV. Provider business mailing address

14913 SW 176TH TER
MIAMI FL
33187-6822
US

V. Phone/Fax

Practice location:
  • Phone: 305-929-0600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH28143
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: