Healthcare Provider Details

I. General information

NPI: 1487718037
Provider Name (Legal Business Name): MR. GUILLERMO PINEIRO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 SW 136 PLACE
MIAMI FL
33184
US

IV. Provider business mailing address

529 SW 136 PLACE
MIAMI FL
33184
US

V. Phone/Fax

Practice location:
  • Phone: 305-724-6990
  • Fax: 305-553-5186
Mailing address:
  • Phone: 305-724-6990
  • Fax: 305-553-5186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: