MEDICARE: MARLEYNA PINON

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	390200000X	Student in an Organized Health Care Education/Training Program
2	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1992248876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLEYNA PINON

Provider Business Mailing Address
First Line	:	4357 N RIO CANCION
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-7172
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2610 MILWAUKEE AVE
Second Line	:	APT. 14H
City	:	LUBBOCK
State	:	TX
Zip	:	79407-1550
Country	:	US
Telephone Number	:	847-846-9110
Fax Number	:

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

Provider Enumeration Date	:	11/28/2016
Last Update Date	:	02/26/2025

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Directions to “ MARLEYNA PINON ” Practice Location

Language	Start Address	Practice Location

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