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NPI Code Detail

MEDICARE: DR. PINA PANCHAL MD

MEDICARE: DR. PINA PANCHAL MD
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
1207Q00000XFamily Medicine PhysicianRTP002343GA
2207Q00000XFamily Medicine PhysicianME113506FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1002343OTHERGATRAINING PERMIT
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902003262
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PINA PANCHAL MD
Provider Business Mailing Address
First Line : 2106 S LOIS AVE
Second Line :
City : TAMPA
State : FL
Zip : 33629-5659
Country : US
Telephone Number : 813-844-4200
Fax Number : 813-844-1919
Provider Business Practice Location Address
First Line : 2106 S LOIS AVE
Second Line :
City : TAMPA
State : FL
Zip : 33629-5659
Country : US
Telephone Number : 813-844-4200
Fax Number : 813-844-1919
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2007
Last Update Date : 07/16/2013

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Directions to “ DR. PINA PANCHAL MD” Practice Location

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