Provider Demographics
NPI:1609428564
Name:PEDROSA, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:PEDROSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8960 SW 199TH ST
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-8972
Mailing Address - Country:US
Mailing Address - Phone:813-793-1181
Mailing Address - Fax:
Practice Address - Street 1:8960 SW 199TH ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-8972
Practice Address - Country:US
Practice Address - Phone:813-793-1181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2023-07-28
Deactivation Date:2022-11-19
Deactivation Code:
Reactivation Date:2023-07-25
Provider Licenses
StateLicense IDTaxonomies
FL11023121363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily