Provider Demographics
NPI:1376801449
Name:DR. AMARYLLIS PASCUAL, PA
Entity Type:Organization
Organization Name:DR. AMARYLLIS PASCUAL, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMARYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCUAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-947-0751
Mailing Address - Street 1:18205 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2106
Mailing Address - Country:US
Mailing Address - Phone:305-947-0751
Mailing Address - Fax:786-288-5267
Practice Address - Street 1:18205 BISCAYNE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-2106
Practice Address - Country:US
Practice Address - Phone:305-947-0751
Practice Address - Fax:786-288-5267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty