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General NPI Number Information
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NPI Number | 1285967869
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Entity Type | Organization
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Legal Business Name | PEDRO U DE LA ROSA COSTA MD PA
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Dates
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Enumeration Date | 09/14/2009
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 1423 ALHAMBRA CIRCLE
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City | CORAL GABLES
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State | FL
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Zip | 33134-3523
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Country | US
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Telephone | 305-273-4777
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Fax |
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Provider Business Mailing Address
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Address Line | 8525 SW 92 ST STE D-15
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City | MIAMI
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State | FL
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Zip | 33156-7356
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Country | US
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Telephone | 305-273-4777
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Fax | 304-273-4770
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PEDRO U DE LA ROSA COSTA
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Credential | MD
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Telephone | 305-273-4777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | ME47729
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License Number State | FL
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