Provider Demographics
NPI:1962174185
Name:PINTO, DIANELLYS (APRN)
Entity type:Individual
Prefix:
First Name:DIANELLYS
Middle Name:
Last Name:PINTO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13136 SIAM DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-1370
Mailing Address - Country:US
Mailing Address - Phone:352-584-1033
Mailing Address - Fax:
Practice Address - Street 1:6279 N LECANTO HWY
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:FL
Practice Address - Zip Code:34465-2503
Practice Address - Country:US
Practice Address - Phone:352-522-0094
Practice Address - Fax:352-522-0098
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11015419363LF0000X
FLRN9509344363LF0000X
FLAPRN11015419363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily