Provider Demographics
NPI:1427032473
Name:JUAN, PEDRO E (MD)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:E
Last Name:JUAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 930
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3000
Mailing Address - Country:US
Mailing Address - Phone:305-442-0028
Mailing Address - Fax:305-442-0126
Practice Address - Street 1:999 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 930
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3000
Practice Address - Country:US
Practice Address - Phone:305-442-0028
Practice Address - Fax:305-442-0126
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMEME84159174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist