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NPI 1588764120

NPI 1588764120 : VICENTE PINO CRNA : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1588764120
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    Entity Type          |    Individual 
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    Provider Name        |    VICENTE PINO CRNA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/24/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2645 SW 37TH AVE SUITE 400
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33133-2754
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    Country              |    US
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    Telephone            |    305-461-3229
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    Fax                  |    954-964-6084
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Provider Business Mailing Address
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    Address Line         |    PO BOX 816759 
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    City                 |    HOLLYWOOD
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    State                |    FL
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    Zip                  |    33081-0759
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    Country              |    US
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    Telephone            |    954-964-2450
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    Fax                  |    954-964-2450
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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        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    ARNP4848842
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    License Number State |    FL
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