Provider Demographics
NPI:1114082088
Name:LUIS F PINEDA MD PC
Entity Type:Organization
Organization Name:LUIS F PINEDA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:PINEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-978-9568
Mailing Address - Street 1:PO BOX 530625
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35253-0625
Mailing Address - Country:US
Mailing Address - Phone:205-978-9568
Mailing Address - Fax:205-823-5086
Practice Address - Street 1:1909 LAUREL RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-1834
Practice Address - Country:US
Practice Address - Phone:205-978-3568
Practice Address - Fax:205-823-5086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAP9400362174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC78877Medicare UPIN
AL000033535Medicare ID - Type Unspecified