Provider Demographics
NPI:1316942105
Name:PINO, JOSEPH J (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:PINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14100 FIVAY RD STE 340
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-7181
Mailing Address - Country:US
Mailing Address - Phone:727-861-0237
Mailing Address - Fax:727-861-0278
Practice Address - Street 1:14100 FIVAY RD STE 340
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7181
Practice Address - Country:US
Practice Address - Phone:727-861-0237
Practice Address - Fax:727-861-0278
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME41058207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D64331Medicare UPIN
FL51214 WMedicare ID - Type Unspecified