Healthcare Provider Details

I. General information

NPI: 1841016029
Provider Name (Legal Business Name): RICHARD PAUL NEMIS PINEDA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 9TH AVE SW STE 104
BESSEMER AL
35022-4502
US

IV. Provider business mailing address

2403 FITZGERALD RD
OXFORD AL
36203-3603
US

V. Phone/Fax

Practice location:
  • Phone: 205-425-5428
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH12107
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: