Healthcare Provider Details

I. General information

NPI: 1083597231
Provider Name (Legal Business Name): OSCAR PINO APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17100 NE 19TH AVE
NORTH MIAMI BEACH FL
33162-3102
US

IV. Provider business mailing address

4353 NW 77TH AVE FL 3
MIAMI FL
33166-6736
US

V. Phone/Fax

Practice location:
  • Phone: 305-204-0333
  • Fax: 305-359-7546
Mailing address:
  • Phone: 305-204-0333
  • Fax: 305-359-7546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11041024
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: