Healthcare Provider Details

I. General information

NPI: 1861622672
Provider Name (Legal Business Name): ROZALYN AGENORIA PASCHAL-THOMAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROZALYN AGENORIA PASCHAL M.D.

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 07/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 NW 27TH AVE SUITE 50
MIAMI FL
33147-4909
US

IV. Provider business mailing address

PO BOX 370608
MIAMI FL
33137-0608
US

V. Phone/Fax

Practice location:
  • Phone: 305-758-0591
  • Fax: 305-836-5445
Mailing address:
  • Phone: 305-758-0591
  • Fax: 305-836-5445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number104396
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: