Healthcare Provider Details

I. General information

NPI: 1770253221
Provider Name (Legal Business Name): AILIN PINO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 NW 25TH AVE
MIAMI FL
33125-1218
US

IV. Provider business mailing address

1901 NW 25TH AVE
MIAMI FL
33125-1218
US

V. Phone/Fax

Practice location:
  • Phone: 786-277-0021
  • Fax:
Mailing address:
  • Phone: 786-277-0021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number9359019
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11022985
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: