Provider Demographics
NPI:1114917978
Name:PINELESS, HAL S (DO)
Entity Type:Individual
Prefix:
First Name:HAL
Middle Name:S
Last Name:PINELESS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1890 STATE ROAD 436
Mailing Address - Street 2:SUITE 255
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2285
Mailing Address - Country:US
Mailing Address - Phone:407-657-7900
Mailing Address - Fax:407-657-7942
Practice Address - Street 1:1890 STATE ROAD 436
Practice Address - Street 2:SUITE 255
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2285
Practice Address - Country:US
Practice Address - Phone:407-657-7900
Practice Address - Fax:407-657-7942
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS00050872084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL82861XMedicare PIN
FLC47349Medicare UPIN