MEDICARE: DANIEL PINEDA PINEDA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-19-95059	FL
2	101YM0800X	Mental Health Counselor	IMH21610	FL

General Provider Information

NPI Number	:	1588211296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL PINEDA PINEDA

Provider Business Mailing Address
First Line	:	918 LAKEWOOD AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-1518
Country	:	US
Telephone Number	:	813-858-9235
Fax Number	:

Provider Business Practice Location Address
First Line	:	918 LAKEWOOD AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-1518
Country	:	US
Telephone Number	:	813-858-9235
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2019
Last Update Date	:	06/28/2024

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Directions to “ DANIEL PINEDA PINEDA ” Practice Location

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