Healthcare Provider Details

I. General information

NPI: 1992944813
Provider Name (Legal Business Name): ROSSY PELLERANO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2009
Last Update Date: 02/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7265 SW 93RD AVE STE 201
MIAMI FL
33173-3656
US

IV. Provider business mailing address

7265 SW 93RD AVE STE 201
MIAMI FL
33173-3656
US

V. Phone/Fax

Practice location:
  • Phone: 305-275-4118
  • Fax: 305-275-0662
Mailing address:
  • Phone: 305-275-4118
  • Fax: 305-275-0662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0002X
TaxonomyObesity Medicine (Psychiatry & Neurology) Physician
License NumberME62811
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: