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General NPI Number Information
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NPI Number | 1568959682
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Entity Type | Individual
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Provider Name | YUDITH PANDO
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Gender | Female
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Dates
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Enumeration Date | 04/13/2018
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Last Update Date | 06/25/2020
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Provider Practice Location Address
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Address Line | 6401 NW 27TH AVE
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City | MIAMI
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State | FL
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Zip | 33147-7734
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Country | US
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Telephone | 305-960-7668
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Fax | 786-310-7347
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Provider Business Mailing Address
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Address Line | 7925 NW 12TH ST STE 201
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City | DORAL
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State | FL
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Zip | 33126-1821
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Country | US
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Telephone | 305-874-3909
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Fax | 305-874-3916
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ARNP9398403
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F04180293
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License Number State | FL
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