MEDICARE: MRS. CAROL PINKSTON BINGERT RD, LD, CDE

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	133V00000X	Registered Dietitian	ND 495	FL

General Provider Information

NPI Number	:	1770776452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROL PINKSTON BINGERT RD, LD, CDE

Provider Business Mailing Address
First Line	:	8383 N DAVIS HWY
Second Line	:	WEST FLORIDA HOSPITAL - THE DIABETES CENTER
City	:	PENSACOLA
State	:	FL
Zip	:	32514-6039
Country	:	US
Telephone Number	:	850-494-4968
Fax Number	:	850-494-6089

Provider Business Practice Location Address
First Line	:	8383 N DAVIS HWY
Second Line	:	WEST FLORIDA HOSPITAL - THE DIABETES CENTER
City	:	PENSACOLA
State	:	FL
Zip	:	32514-6039
Country	:	US
Telephone Number	:	850-494-4968
Fax Number	:	850-494-6089

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

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	08/24/2007

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