MEDICARE: DR. RONNIE PIMENTEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME63413	FL
2	207RG0100X	Gastroenterology Physician	ME63413	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003818188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONNIE PIMENTEL M.D.

Provider Business Mailing Address
First Line	:	2950 CLEVELAND CLINIC BLV BLVD
Second Line	:	CLEVELAN CLINIC FLORIDA
City	:	WESTON
State	:	FL
Zip	:	33331
Country	:	US
Telephone Number	:	309-762-5560
Fax Number	:	309-762-7351

Provider Business Practice Location Address
First Line	:	2950 CLEVELAND CLINIC BLVD
Second Line	:	CLEVALAND CLINIC FLORIDA DEPARTMENT OF GASTROENTEROLOGY
City	:	WESTON
State	:	FL
Zip	:	33331
Country	:	US
Telephone Number	:	309-762-5560
Fax Number	:	309-762-7351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	09/19/2022

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