Healthcare Provider Details

I. General information

NPI: 1891675997
Provider Name (Legal Business Name): PAULINE GARSOTA TOLENTINO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 NW 48TH ST
MIAMI FL
33127-2323
US

IV. Provider business mailing address

751 NW 48TH ST
MIAMI FL
33127-2323
US

V. Phone/Fax

Practice location:
  • Phone: 281-221-3013
  • Fax:
Mailing address:
  • Phone: 281-221-3013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number40914
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: