Individual
EDGARDO B. PENABAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7590 NW 186TH ST, HIALEAH, FL 33015-2952
(786) 953-6293
(786) 953-6891
Mailing address
7590 NW 186TH ST, HIALEAH, FL 33015-2952
(786) 953-6293
(786) 953-6891
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME65669
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
375873700
—
FL
Enumeration date
09/22/2006
Last updated
12/20/2023
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