Provider Demographics
NPI:1548056211
Name:PEDRERO, KIMBERLY KAY (RN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KAY
Last Name:PEDRERO
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17831 NW 84TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2501
Mailing Address - Country:US
Mailing Address - Phone:786-493-8845
Mailing Address - Fax:
Practice Address - Street 1:15150 BULL RUN RD
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2167
Practice Address - Country:US
Practice Address - Phone:305-317-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9671649163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse