Healthcare Provider Details

I. General information

NPI: 1609497668
Provider Name (Legal Business Name): STEPHANIE PINEIRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2020
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 SHERIDAN ST STE 156
PEMBROKE PINES FL
33024-8801
US

IV. Provider business mailing address

18205 NW 73RD AVE APT 305
HIALEAH FL
33015-6191
US

V. Phone/Fax

Practice location:
  • Phone: 352-554-9204
  • Fax:
Mailing address:
  • Phone: 786-612-4687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH25544
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: