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General NPI Number Information
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NPI Number | 1538437918
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Entity Type | Organization
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Legal Business Name | JORGE F PIMIENTA MD INC
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 11760 SW 40TH ST SUITE 542
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City | MIAMI
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State | FL
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Zip | 33175-3582
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Country | US
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Telephone | 305-554-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 1421 SW 107TH AVE #147
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City | MIAMI
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State | FL
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Zip | 33174-2526
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Country | US
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Telephone | 305-554-7575
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. LESLY MARTELL
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Credential |
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Telephone | 305-554-7575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | ME0067199
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License Number State | FL
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