Healthcare Provider Details

I. General information

NPI: 1013955632
Provider Name (Legal Business Name): ERNESTO PINZON PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 ALT US HWY 27 S SUITE A
SEBRING FL
33870-4973
US

IV. Provider business mailing address

2950 ALT US HWY 27 S SUITE A
SEBRING FL
33870-4973
US

V. Phone/Fax

Practice location:
  • Phone: 863-471-1300
  • Fax: 863-471-1315
Mailing address:
  • Phone: 863-471-1300
  • Fax: 863-471-1315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: ERNESTO PINZON
Title or Position: OWNER
Credential: MD
Phone: 863-471-1300