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General NPI Number Information
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NPI Number | 1407408677
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Entity Type | Organization
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Legal Business Name | PINES HEALTH CENTER INC
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Dates
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Enumeration Date | 07/09/2019
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 7911 NW 72ND AVE STE 111
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City | MEDLEY
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State | FL
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Zip | 33166-2221
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Country | US
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Telephone | 305-888-6959
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Fax | 305-887-8198
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Provider Business Mailing Address
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Address Line | PO BOX 521044
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City | MIAMI
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State | FL
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Zip | 33152-1044
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Country | US
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Telephone | 305-888-6959
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Fax | 305-887-8198
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAYNIER MOYA
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Credential | MD
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Telephone | 305-776-5822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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