Provider Demographics
NPI:1104891019
Name:PINERO, RAFAEL E (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:E
Last Name:PINERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2766 E. COLONIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5025
Mailing Address - Country:US
Mailing Address - Phone:407-426-9693
Mailing Address - Fax:407-426-9694
Practice Address - Street 1:2766 E. COLONIAL DRIVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5025
Practice Address - Country:US
Practice Address - Phone:407-426-9693
Practice Address - Fax:407-426-9694
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73160207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL41542WOtherMEDICARE
FLG63331Medicare UPIN
FLG63331Medicare UPIN