Provider Demographics
NPI:1801882899
Name:FIERRO-COBAS, VICTORIA HELENA (MD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:HELENA
Last Name:FIERRO-COBAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 SW 62ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3009
Mailing Address - Country:US
Mailing Address - Phone:305-666-6511
Mailing Address - Fax:
Practice Address - Street 1:3100 SW 62ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3009
Practice Address - Country:US
Practice Address - Phone:305-666-6511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77153208000000X, 2080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL232943OtherWELLCARE PROVIDER NUMBER
FL114669OtherHUMANA PROVIDER NUMBER
FL37644OtherBCBS PROVIDER NUMBER
FL7028179OtherAETNA PROVIDER NUMBER
FL562428594OtherTAX ID
FL269038100Medicaid
FL40779OtherNHP PROVIDER NUMBER
H67556Medicare UPIN