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General NPI Number Information
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NPI Number | 1215333943
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Entity Type | Individual
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Provider Name | THOMAS DONATO PINO PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/06/2014
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 632 DEL PRADO BLVD N
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City | CAPE CORAL
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State | FL
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Zip | 33909-2278
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Country | US
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Telephone | 239-829-7102
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Fax |
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Provider Business Mailing Address
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Address Line | 151 SOUTHHALL LANE SUITE 300
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City | MAITLAND
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State | FL
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Zip | 32751-7157
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Country | US
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Telephone | 866-400-3376
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Fax | 407-650-3455
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | PA9108370
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9108370
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License Number State | FL
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