Provider Demographics
NPI:1740303460
Name:REIMONDO, PEDRO D (PA)
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:D
Last Name:REIMONDO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:150 NW 168TH ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6045
Mailing Address - Country:US
Mailing Address - Phone:305-932-7685
Mailing Address - Fax:305-860-8255
Practice Address - Street 1:150 NW 168TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-6045
Practice Address - Country:US
Practice Address - Phone:305-944-1122
Practice Address - Fax:305-944-1133
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9100747363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant