Provider Demographics
NPI:1700694718
Name:MIGUEL-SOCA, PEDRO ENRIQUE
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:ENRIQUE
Last Name:MIGUEL-SOCA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 S UNIVERSITY DR APT 7305
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-5340
Mailing Address - Country:US
Mailing Address - Phone:786-482-3921
Mailing Address - Fax:
Practice Address - Street 1:7000 W 12TH AVE STE 15
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5154
Practice Address - Country:US
Practice Address - Phone:305-395-4919
Practice Address - Fax:305-395-4920
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1702207QA0505X
PR16875I207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine