Healthcare Provider Details

I. General information

NPI: 1740259456
Provider Name (Legal Business Name): MRS. HORTENSIA PINEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12811 SW 43RD DR 121A
MIAMI FL
33175-4179
US

IV. Provider business mailing address

12811 SW 43RD DR
MIAMI FL
33175-4179
US

V. Phone/Fax

Practice location:
  • Phone: 305-485-8431
  • Fax: 305-485-8431
Mailing address:
  • Phone: 305-485-8431
  • Fax: 305-485-8431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: