Healthcare Provider Details
I. General information
NPI: 1467367094
Provider Name (Legal Business Name): ROCIO PESTANA, MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5995 SW 71ST ST STE 403B
SOUTH MIAMI FL
33143-3531
US
IV. Provider business mailing address
5995 SW 71ST ST STE 403B
SOUTH MIAMI FL
33143-3531
US
V. Phone/Fax
- Phone: 305-665-6926
- Fax:
- Phone: 305-665-6926
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LISA
SOSA
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 305-549-8937