Healthcare Provider Details

I. General information

NPI: 1508437609
Provider Name (Legal Business Name): MARILIA RITA PINZONE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 04/17/2025
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 S TAYLOR AVE DIV IM INFECTIOUS DISEASE, STE 100
SAINT LOUIS MO
63110-1035
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-747-1206
  • Fax: 314-454-5392
Mailing address:
  • Phone: 314-747-1206
  • Fax: 314-454-5392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number2024026013
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: