Provider Demographics
NPI:1093754392
Name:PINES MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:PINES MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTES DE OCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-450-6671
Mailing Address - Street 1:18503 PINES BLVD
Mailing Address - Street 2:SUITE 313
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029
Mailing Address - Country:US
Mailing Address - Phone:954-450-6671
Mailing Address - Fax:
Practice Address - Street 1:18503 PINES BLVD
Practice Address - Street 2:SUITE 313
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029
Practice Address - Country:US
Practice Address - Phone:954-450-6671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies