Provider Demographics
NPI:1033352331
Name:PIPINO, MICHELLE H (ARNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:H
Last Name:PIPINO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 499
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-0499
Mailing Address - Country:US
Mailing Address - Phone:941-776-4000
Mailing Address - Fax:
Practice Address - Street 1:6320 VENTURE DR
Practice Address - Street 2:SUITE 205
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5130
Practice Address - Country:US
Practice Address - Phone:941-924-9955
Practice Address - Fax:941-924-5616
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9165852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001675300Medicaid
FLBT686YMedicare PIN