Provider Demographics
NPI:1568822724
Name:PASTORA, BEVERLY (CRNA)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:PASTORA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 SAN REMO AVE
Mailing Address - Street 2:285
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3043
Mailing Address - Country:US
Mailing Address - Phone:305-448-9018
Mailing Address - Fax:305-448-1895
Practice Address - Street 1:5000 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2008
Practice Address - Country:US
Practice Address - Phone:305-448-9018
Practice Address - Fax:305-448-1895
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-02
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9234018367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered