MEDICARE: BRYAN PINERO

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	183500000X	Pharmacist	PSI32995	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PSI32995	OTHER	FL	DEPARTMENT OF HEALTH

General Provider Information

NPI Number	:	1417346982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYAN PINERO

Provider Business Mailing Address
First Line	:	7706 NOTTINGHILL SKY DR
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-1527
Country	:	US
Telephone Number	:	941-720-0210
Fax Number	:

Provider Business Practice Location Address
First Line	:	7706 NOTTINGHILL SKY DR
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-1527
Country	:	US
Telephone Number	:	941-720-0210
Fax Number	:

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

Provider Enumeration Date	:	01/21/2015
Last Update Date	:	01/21/2015

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Directions to “ BRYAN PINERO ” Practice Location

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