Provider Demographics
NPI:1194858886
Name:PEDI-EVE, INC.
Entity type:Organization
Organization Name:PEDI-EVE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:REINALDO
Authorized Official - Last Name:ALAM-GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-444-9494
Mailing Address - Street 1:2721 S COBB DR SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-3240
Mailing Address - Country:US
Mailing Address - Phone:770-444-9494
Mailing Address - Fax:770-436-4656
Practice Address - Street 1:2721 S COBB DR SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-3240
Practice Address - Country:US
Practice Address - Phone:770-444-9494
Practice Address - Fax:770-436-4656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261QP2300X, 261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Not Answered261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine