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General NPI Number Information
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NPI Number | 1659247096
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Entity Type | Organization
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Legal Business Name | PESTANA COMPREHENSIVE WELLNESS
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 3100 CORAL HILLS DR STE 201
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4139
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Country | US
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Telephone | 954-755-8844
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Fax | 754-240-3211
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Provider Business Mailing Address
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Address Line | 3100 CORAL HILLS DR STE 201
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4139
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Country | US
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Telephone | 954-755-8844
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Fax | 754-240-3211
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Authorized Official
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Title or Position | PRESIDENT, PHYSICIAN
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Name | TATIANA A PESTANA
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Credential | MD, MPH, CCMS, IFMCP
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Telephone | 954-599-5829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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