Healthcare Provider Details
I. General information
NPI: 1639387525
Provider Name (Legal Business Name): ROZALYN HESTER PASCHAL MD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2007
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7900 NW 27TH AVE SUITE 50
MIAMI FL
33147-4902
US
IV. Provider business mailing address
PO BOX 370608
MIAMI FL
33137-0608
US
V. Phone/Fax
- Phone: 305-758-0591
- Fax: 305-836-5445
- Phone: 305-758-0591
- Fax: 305-836-5445
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME030785 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
ROZALYN
AGENORIA
PASCHAL-THOMAS
Title or Position: OWNER
Credential: M.D.
Phone: 305-758-0591