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General NPI Number Information
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NPI Number | 1639970205
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Entity Type | Organization
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Legal Business Name | MEDPRO CS, LLC
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 8851 NW 119TH ST UNIT 3206
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City | HIALEAH
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State | FL
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Zip | 33018-7909
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Country | US
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Telephone | 305-910-6091
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Fax | 857-336-1383
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Provider Business Mailing Address
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Address Line | 8851 NW 119TH ST UNIT 3206
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City | HIALEAH
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State | FL
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Zip | 33018-7909
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Country | US
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Telephone | 305-910-6091
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Fax | 857-336-1383
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Authorized Official
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Title or Position | CEO
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Name | DENIA PEDROSO
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Credential | APRN, AGACNP-BC, PMH
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Telephone | 305-910-6091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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