Healthcare Provider Details

I. General information

NPI: 1902071939
Provider Name (Legal Business Name): PEDRO ANTONIO SEVILLA SAEZ-BENITO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 04/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 SW 97TH AVE STE 120
MIAMI FL
33173-1474
US

IV. Provider business mailing address

PO BOX 562435
MIAMI FL
33256-2435
US

V. Phone/Fax

Practice location:
  • Phone: 786-299-5419
  • Fax: 844-431-6801
Mailing address:
  • Phone: 786-299-5419
  • Fax: 844-431-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME0107719
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME107719
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: