Healthcare Provider Details

I. General information

NPI: 1477722437
Provider Name (Legal Business Name): AMALIA ROSALYN PINEDA MD,SA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 NW 95TH ST SUITE 306
MIAMI FL
33150-2063
US

IV. Provider business mailing address

1190 NW 95TH ST SUITE 306
MIAMI FL
33150-2063
US

V. Phone/Fax

Practice location:
  • Phone: 305-218-7203
  • Fax: 305-693-0049
Mailing address:
  • Phone: 305-218-7203
  • Fax: 305-693-0049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number07-179
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: