Provider Demographics
NPI:1528299526
Name:ESCUDERO, PEDRO
Entity type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:
Last Name:ESCUDERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 SW 8TH ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4263
Mailing Address - Country:US
Mailing Address - Phone:305-392-0004
Mailing Address - Fax:305-392-0006
Practice Address - Street 1:8150 SW 8TH ST
Practice Address - Street 2:SUITE 212
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4263
Practice Address - Country:US
Practice Address - Phone:305-392-0004
Practice Address - Fax:305-392-0006
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2025-09-25
Deactivation Date:2025-04-27
Deactivation Code:
Reactivation Date:2025-09-25
Provider Licenses
StateLicense IDTaxonomies
FLMA44688172M00000X
172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Single Specialty