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General NPI Number Information
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NPI Number | 1700326758
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Entity Type | Organization
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Legal Business Name | JULIO PEGUERO, M.D. PLLC
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Dates
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Enumeration Date | 02/24/2017
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Last Update Date | 02/24/2017
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Provider Practice Location Address
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Address Line | 8011 NW 159TH TER
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City | MIAMI LAKES
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State | FL
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Zip | 33016-6664
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Country | US
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Telephone | 305-244-5344
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Fax |
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Provider Business Mailing Address
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Address Line | 8011 NW 159TH TER
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City | MIAMI LAKES
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State | FL
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Zip | 33016-6664
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Country | US
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Telephone | 305-244-5344
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Fax |
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Authorized Official
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Title or Position | CARDIOLOGIST
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Name | DR. JULIO GABRIEL PEGUERO
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Credential | M.D.
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Telephone | 305-244-5344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME 125573
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License Number State | FL
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