Provider Demographics
NPI:1386396208
Name:PINA, JOANNE (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:PINA
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 NW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-4933
Mailing Address - Country:US
Mailing Address - Phone:786-333-6316
Mailing Address - Fax:
Practice Address - Street 1:1810 NW 17TH ST
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-4933
Practice Address - Country:US
Practice Address - Phone:786-333-6316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY141893202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology