Organization
EP MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ESTILITA PASCUAL M.D. (PRESIDENT)
(305) 213-3238
Entity
Organization
Contact information
Practice address
4980 W 10TH AVE STE 101, HIALEAH, FL 33012-3437
(305) 819-5583
(305) 819-5643
Mailing address
4980 W 10TH AVE STE 101, HIALEAH, FL 33012-3437
(305) 819-5583
(305) 819-5643
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0063839
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372599500
—
FL
Enumeration date
04/09/2014
Last updated
04/09/2014
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