Provider Demographics
NPI:1952566432
Name:BERNARDO PASCUAL M D P A
Entity Type:Organization
Organization Name:BERNARDO PASCUAL M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCUAL
Authorized Official - Suffix:
Authorized Official - Credentials:M D P A
Authorized Official - Phone:305-822-2818
Mailing Address - Street 1:17670 NW 78TH AVE
Mailing Address - Street 2:STE 211
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3670
Mailing Address - Country:US
Mailing Address - Phone:305-822-2818
Mailing Address - Fax:305-827-4815
Practice Address - Street 1:17670 NW 78TH AVE
Practice Address - Street 2:STE 211
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3670
Practice Address - Country:US
Practice Address - Phone:305-822-2818
Practice Address - Fax:305-827-4815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373168500Medicaid
FLF63795Medicare UPIN
FL23085Medicare PIN