Healthcare Provider Details

I. General information

NPI: 1881773521
Provider Name (Legal Business Name): ESTELA PINNAVARIA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15173 NE 21 AVE
NORTH MIAMI BEACH FL
33154
US

IV. Provider business mailing address

9250 W BAY HARBOR DR # 7B
BAY HARBOR ISL FL
33154
US

V. Phone/Fax

Practice location:
  • Phone: 305-354-4664
  • Fax: 305-354-4669
Mailing address:
  • Phone: 305-354-4664
  • Fax: 305-354-4669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPH17703
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: