Provider Demographics
NPI:1851786461
Name:MASCARO, PEDRO GABRIEL (MD)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:GABRIEL
Last Name:MASCARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2629 WINDGUARD CIR STE 102
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7355
Mailing Address - Country:US
Mailing Address - Phone:813-388-2948
Mailing Address - Fax:813-388-6827
Practice Address - Street 1:325 CLYDE MORRIS BLVD STE 400
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8185
Practice Address - Country:US
Practice Address - Phone:386-671-0600
Practice Address - Fax:386-677-9710
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME145862207LP2900X
TNPENDING207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine