MEDICARE: PEDRO A ESPAT DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	OS6265	FL

General Provider Information

NPI Number	:	1629513742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDRO A ESPAT DO

Provider Business Mailing Address
First Line	:	8005 BAY ST
Second Line	:	SUITE 3
City	:	SEBASTIAN
State	:	FL
Zip	:	32958-3244
Country	:	US
Telephone Number	:	772-589-5600
Fax Number	:	772-589-9449

Provider Business Practice Location Address
First Line	:	8005 BAY ST
Second Line	:	SUITE 3
City	:	SEBASTIAN
State	:	FL
Zip	:	32958-3244
Country	:	US
Telephone Number	:	772-589-5600
Fax Number	:	772-589-9449

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	SHARON GORE
Credential	:
Telephone Number	:	772-589-5600

Provider Enumeration Date	:	12/28/2016
Last Update Date	:	12/28/2016

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Directions to “PEDRO A ESPAT DO ” Practice Location

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