NPIMap

Organization Active NPI

Pedroso Pediatrics PA

  • Pediatrics Physician
  • Hollywood, FL
National Provider Identifier
1104068113
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME73710 Issued in FL
Legal business name
PEDROSO PEDIATRICS PA
Practice address
2647 Hollywood Blvd
Hollywood, FL 33020-4840
Phone
(954) 923-9494
Fax
(877) 286-3853
NPI assigned
Apr 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Manuel Pedroso, M.D.NPI 1851464077
Title
President
Phone
(954) 923-9494

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X ME73710 FL Primary

Addresses

Primary practice location

2647 Hollywood Blvd
Hollywood, FL 33020-4840

Mailing address

2647 Hollywood Blvd
Hollywood, FL 33020-4840
Phone (954) 923-9494

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DRP@PEDROSOPEDIATRICS.COMCASTBIZ.NET Direct

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0970001Pedroso Pediatrics PA2647 Hollywood Blvd, Hollywood, FL 33020ComplianceMar 26, 2027

National Provider Directory

National Provider Directory

Locations

117 S 17th Ave
Hollywood, FL 33020

Interoperability endpoints

  • Direct secure messaging: drp@pedrosopediatrics.comcastbiz.net

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1104068113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2647 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204840",
            "telephone_number": "954-923-9494",
            "fax_number": "954-923-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2647 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204840",
            "telephone_number": "954-923-9494",
            "fax_number": "877-286-3853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDROSO PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-06",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A",
        "authorized_official_last_name": "PEDROSO",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-923-9494",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME73710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DRP@PEDROSOPEDIATRICS.COMCASTBIZ.NET",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2647 Hollywood Blvd",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330204840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.