Healthcare Provider Details
I. General information
NPI: 1427971027
Provider Name (Legal Business Name): THE PINK PRACTICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2877 TURK BLVD
SAN FRANCISCO CA
94118-4350
US
IV. Provider business mailing address
1317 EDGEWATER DR STE 7721
ORLANDO FL
32804-6350
US
V. Phone/Fax
- Phone: 301-356-5679
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CAMILLE
BARONI
ENGLE
Title or Position: AUTHORIZED OFFICIAL/OWNER
Credential: APRN, FNP-C
Phone: 301-356-5679