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General NPI Number Information
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NPI Number | 1629513742
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Entity Type | Organization
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Legal Business Name | PEDRO A ESPAT DO
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Dates
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Enumeration Date | 12/28/2016
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Last Update Date | 12/28/2016
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Provider Practice Location Address
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Address Line | 8005 BAY ST SUITE 3
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City | SEBASTIAN
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State | FL
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Zip | 32958-3244
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Country | US
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Telephone | 772-589-5600
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Fax | 772-589-9449
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Provider Business Mailing Address
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Address Line | 8005 BAY ST SUITE 3
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City | SEBASTIAN
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State | FL
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Zip | 32958-3244
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Country | US
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Telephone | 772-589-5600
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Fax | 772-589-9449
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SHARON GORE
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Credential |
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Telephone | 772-589-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS6265
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License Number State | FL
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