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General NPI Number Information
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NPI Number | 1104988401
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Entity Type | Organization
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Legal Business Name | PASADENA PEDITARICS, P.A.
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 2476 N UNIVERSITY DR
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3624
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Country | US
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Telephone | 954-436-0068
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Fax | 954-431-5006
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Provider Business Mailing Address
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Address Line | 2476 N UNIVERSITY DR
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3624
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Country | US
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Telephone | 954-436-0068
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Fax | 954-431-5006
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIA ISABEL CLEMENTE
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Credential | MD
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Telephone | 954-659-8550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME52086
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License Number State | FL
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