Provider Demographics
NPI:1942277868
Name:DE LA ROSA-COSTA, PEDRO U (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:U
Last Name:DE LA ROSA-COSTA
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1423 ALHAMBRA CIR
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3523
Mailing Address - Country:US
Mailing Address - Phone:305-643-6500
Mailing Address - Fax:305-642-4995
Practice Address - Street 1:8525 SW 92ND. STREET
Practice Address - Street 2:SUITE: D- 15
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-5683
Practice Address - Country:US
Practice Address - Phone:305-273-4777
Practice Address - Fax:305-273-4770
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 0047729207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL044901600Medicaid
FLD50497Medicare UPIN
FL044901600Medicaid