Provider Demographics
NPI:1073843835
Name:PINTO, EDUARDO P (SAC)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:P
Last Name:PINTO
Suffix:
Gender:M
Credentials:SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8102 NW 158TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-7119
Mailing Address - Country:US
Mailing Address - Phone:305-558-2787
Mailing Address - Fax:
Practice Address - Street 1:8102 NW 158TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-7119
Practice Address - Country:US
Practice Address - Phone:305-558-2787
Practice Address - Fax:305-819-9714
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO09188246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09188OtherAMERICAN BOARD OF SURGICAL ASSISTANTS