Provider Demographics
NPI:1639387525
Name:ROZALYN HESTER PASCHAL MD PA
Entity Type:Organization
Organization Name:ROZALYN HESTER PASCHAL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROZALYN
Authorized Official - Middle Name:AGENORIA
Authorized Official - Last Name:PASCHAL-THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-758-0591
Mailing Address - Street 1:PO BOX 370608
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-0608
Mailing Address - Country:US
Mailing Address - Phone:305-758-0591
Mailing Address - Fax:305-836-5445
Practice Address - Street 1:7900 NW 27TH AVE
Practice Address - Street 2:SUITE 50
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-4902
Practice Address - Country:US
Practice Address - Phone:305-758-0591
Practice Address - Fax:305-836-5445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME030785208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL119644400Medicaid
FL378774500Medicaid
FL102059200Medicaid