Provider Demographics
NPI:1174558035
Name:PIERRE, EDGAR (MD)
Entity type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:
Last Name:PIERRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 SW 92ND STREET
Mailing Address - Street 2:SUITE 204A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156
Mailing Address - Country:US
Mailing Address - Phone:305-216-7312
Mailing Address - Fax:305-500-2137
Practice Address - Street 1:8900 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2118
Practice Address - Country:US
Practice Address - Phone:305-661-9404
Practice Address - Fax:305-661-1510
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75360207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2553783-00Medicaid
FLE08304Medicare PIN
FL2553783-00Medicaid