Maryse Anne Pedoussaut, M.D

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

ME 82118 Issued in FL

Practice address

800 SW 108TH Ave Ste 100
Miami, FL 33174

Phone

(305) 348-3627

Fax

(305) 348-4261

NPI assigned

Jun 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: maryse.pedoussaut.1@27920.direct.athenahealth.com
• Direct secure messaging: maryse.pedoussaut.1@14931.direct.athenahealth.com

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1881639458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SW 108TH AVENUE, SUITE 100",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330146540",
            "telephone_number": "305-348-3627",
            "fax_number": "305-348-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SW 108TH AVE STE 100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33174",
            "telephone_number": "305-348-3627",
            "fax_number": "305-348-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDOUSSAUT",
        "first_name": "MARYSE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME 82118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2633906",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pedikidz of Florida Corp
• Pedikidz Ppec
• Pediride, LLC
• Pedo Ortho Dental Specialists LLC
• Anais Pedoussaut, PA-C
• Alexandra Jade Pedowitz, MD, MPH
• Milaidys Pedraja, DMD
• Victoria Maria Pedraja
• Beatriz Pedrayes Gomez
• Noel E Pedraza Alonso

• Adult Medicine Physician in Miami, FL
• Providers in Miami, FL by specialty
• Adult Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.