Provider Demographics
NPI:1578797486
Name:PEDROSO, FELIPE EDUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:FELIPE
Middle Name:EDUARDO
Last Name:PEDROSO
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 1:3200 SW 60TH CT
Mailing Address - Street 2:STE 201
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4070
Mailing Address - Country:US
Mailing Address - Phone:305-302-4416
Mailing Address - Fax:
Practice Address - Street 1:3200 SW 60TH CT STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4070
Practice Address - Country:US
Practice Address - Phone:305-302-4416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2867382086S0120X
FL1468202086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric SurgeryGroup - Multi-Specialty