Provider Demographics
NPI:1063494227
Name:PEDRO-ALEXANDER, VERONICA (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:PEDRO-ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10131 W FOREST HILL BLVD
Mailing Address - Street 2:STE 230
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6156
Mailing Address - Country:US
Mailing Address - Phone:561-798-6600
Mailing Address - Fax:561-753-3328
Practice Address - Street 1:440 N STATE ROAD 7
Practice Address - Street 2:STE C
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3504
Practice Address - Country:US
Practice Address - Phone:561-798-6600
Practice Address - Fax:561-753-3328
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0073478207XS0106X
FLME73478207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL25138500Medicaid
FL41392Medicare ID - Type Unspecified
FL25138500Medicaid