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General NPI Number Information
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NPI Number | 1346554094
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Entity Type | Organization
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Legal Business Name | JOSEPH PINO MD PA
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 08/04/2010
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Provider Practice Location Address
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Address Line | 13906 LAKESHORE BLVD SUITE 340
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City | HUDSON
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State | FL
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Zip | 34667-1487
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Country | US
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Telephone | 727-863-7000
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Fax | 727-863-7007
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Provider Business Mailing Address
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Address Line | 13906 LAKESHORE BLVD SUITE 340
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City | HUDSON
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State | FL
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Zip | 34667-1487
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Country | US
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Telephone | 727-863-7000
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Fax | 727-863-7007
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH PINO
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Credential | M.D.
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Telephone | 727-863-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME0041058
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License Number State | FL
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