Provider Demographics
NPI:1861622672
Name:PASCHAL-THOMAS, ROZALYN AGENORIA (MD)
Entity type:Individual
Prefix:
First Name:ROZALYN
Middle Name:AGENORIA
Last Name:PASCHAL-THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROZALYN
Other - Middle Name:AGENORIA
Other - Last Name:PASCHAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 370608
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-0608
Mailing Address - Country:US
Mailing Address - Phone:305-758-0591
Mailing Address - Fax:305-836-5445
Practice Address - Street 1:7900 NW 27TH AVE
Practice Address - Street 2:SUITE 50
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-4909
Practice Address - Country:US
Practice Address - Phone:305-758-0591
Practice Address - Fax:305-836-5445
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL104396208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics