Provider Demographics
NPI:1043781651
Name:CLAUDIO PINERO, MEILYN
Entity Type:Individual
Prefix:
First Name:MEILYN
Middle Name:
Last Name:CLAUDIO PINERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 YUCATAN DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-4964
Mailing Address - Country:US
Mailing Address - Phone:407-617-2143
Mailing Address - Fax:
Practice Address - Street 1:6515 YUCATAN DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-4964
Practice Address - Country:US
Practice Address - Phone:407-617-2143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-07
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC431540879560OtherDRIVERS LICENSE