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General NPI Number Information
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NPI Number | 1710278445
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Entity Type | Individual
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Provider Name | ELENA V. PIMANOVA MD
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Gender | Female
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 3250 MERIDIAN PKWY
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City | WESTON
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State | FL
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Zip | 33331-3502
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Country | US
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Telephone | 954-659-5867
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Fax | 954-659-5868
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Provider Business Mailing Address
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Address Line | 101 W MULBERRY BLVD STE 100
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City | SAVANNAH
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State | GA
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Zip | 31407-3507
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Country | US
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Telephone | 912-350-6000
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Fax | 912-350-6001
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 071614
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License Number State | GA
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