Provider Demographics
NPI:1659247096
Name:PESTANA COMPREHENSIVE WELLNESS
Entity type:Organization
Organization Name:PESTANA COMPREHENSIVE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TATIANA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PESTANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH, CCMS, IFMCP
Authorized Official - Phone:954-599-5829
Mailing Address - Street 1:3100 CORAL HILLS DR STE 201
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4139
Mailing Address - Country:US
Mailing Address - Phone:954-755-8844
Mailing Address - Fax:754-240-3211
Practice Address - Street 1:3100 CORAL HILLS DR STE 201
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4139
Practice Address - Country:US
Practice Address - Phone:954-755-8844
Practice Address - Fax:754-240-3211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty