Healthcare Provider Details
I. General information
NPI: 1578797486
Provider Name (Legal Business Name): FELIPE EDUARDO PEDROSO MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/06/2009
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3200 SW 60TH CT STE 201
MIAMI FL
33155-4070
US
IV. Provider business mailing address
3200 SW 60TH CT STE 201
MIAMI FL
33155-4070
US
V. Phone/Fax
- Phone: 305-662-8320
- Fax:
- Phone: 305-662-8320
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0120X |
| Taxonomy | Pediatric Surgery Physician |
| License Number | 286738 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0120X |
| Taxonomy | Pediatric Surgery Physician |
| License Number | ME-146820 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: