Provider Demographics
NPI:1487085254
Name:PILOTO RODRIGUEZ, OSMANI (MD)
Entity type:Individual
Prefix:
First Name:OSMANI
Middle Name:
Last Name:PILOTO RODRIGUEZ
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 1:139 S PEBBLE BEACH BLVD
Mailing Address - Street 2:STE 207
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-5799
Mailing Address - Country:US
Mailing Address - Phone:813-633-4000
Mailing Address - Fax:813-633-4001
Practice Address - Street 1:139 S PEBBLE BEACH BLVD
Practice Address - Street 2:STE 207
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5799
Practice Address - Country:US
Practice Address - Phone:813-633-4000
Practice Address - Fax:813-633-4001
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-04
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL119427207R00000X
282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHX250ZMedicare PIN