Provider Demographics
NPI:1073789491
Name:NORBERTO PEDROSO MD PA
Entity Type:Organization
Organization Name:NORBERTO PEDROSO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORBERTO
Authorized Official - Middle Name:JESUS
Authorized Official - Last Name:PEDROSO MONTESINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-458-5612
Mailing Address - Street 1:5078 SW 168TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4914
Mailing Address - Country:US
Mailing Address - Phone:305-458-5612
Mailing Address - Fax:
Practice Address - Street 1:5078 SW 168TH AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4914
Practice Address - Country:US
Practice Address - Phone:305-458-5612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 100918207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty