Basic Information
| Provider Information | |||||||||
| NPI: | 1336113034 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PESETSKY | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | JOEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5200 NE 2ND AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331372706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3057518626 | ||||||||
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| Practice Location | |||||||||
| Address1: | 16736 SAPPHIRE ISLE | ||||||||
| Address2: | |||||||||
| City: | WESTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333313175 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545312233 | ||||||||
| FaxNumber: | 9543858373 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2006 | ||||||||
| LastUpdateDate: | 11/07/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0002X | ME 62813 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine |
No ID Information.