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General NPI Number Information
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NPI Number | 1871559971
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Entity Type | Individual
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Provider Name | SERGIO N/A PINEIRO JR. D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 07/16/2023
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Provider Practice Location Address
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Address Line | 500 MEMORIAL CIR SUITE B
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5054
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Country | US
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Telephone | 386-673-8040
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Fax | 386-267-0693
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Provider Business Mailing Address
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Address Line | 500 MEMORIAL CIR SUITE B
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5054
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Country | US
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Telephone | 386-673-8040
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Fax | 386-267-0693
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 05440
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | OS5971
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License Number State | FL
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