Doctor Name: | EUGENE PESANT |
NPI Number: | 1164810834 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | SW10789 |
Business Practice Address: | 10300 Sw 216th St Cutler Bay, FL - 331901003 |
Business Phone Number: | 7862452761 |
Business Fax Number: | 7862452775 |
Mailing Address: | 10300 Sw 216th St, CUTLER BAY |
State: | FL |
Postal Code: | 331901003 |
Phone Number: | 7862452761 |
Fax Number: | 7862452775 |
NPI Enumeration Date: | 01/05/2015 |
NPI Last Update Date: | 02/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | SW10789 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |