Provider Demographics
NPI:1629430756
Name:PEDRO SEVILLA LLC
Entity Type:Organization
Organization Name:PEDRO SEVILLA LLC
Other - Org Name:MIAMI PULMONARY SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:A
Authorized Official - Last Name:SEVILLA SAEZ-BENITO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-299-5419
Mailing Address - Street 1:PO BOX 562435
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-2435
Mailing Address - Country:US
Mailing Address - Phone:786-299-5419
Mailing Address - Fax:844-431-6801
Practice Address - Street 1:7000 SW 97TH AVE STE 120
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1474
Practice Address - Country:US
Practice Address - Phone:786-299-5419
Practice Address - Fax:844-431-6801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-28
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR9V8AOtherBCBS
FLIP950AMedicare PIN