Healthcare Provider Details

I. General information

NPI: 1902392251
Provider Name (Legal Business Name): KARA MARIE PINERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 S KINGS AVE STE 3000
BRANDON FL
33511-6060
US

IV. Provider business mailing address

PO BOX 748817
ATLANTA GA
30374-8817
US

V. Phone/Fax

Practice location:
  • Phone: 813-681-6625
  • Fax: 813-684-6043
Mailing address:
  • Phone: 813-286-0033
  • Fax: 813-282-1806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN9325789
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: