Provider Demographics
NPI:1154815710
Name:PINNOCK, VENICE (APRN)
Entity Type:Individual
Prefix:MS
First Name:VENICE
Middle Name:
Last Name:PINNOCK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 SABAL PALM DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-4559
Mailing Address - Country:US
Mailing Address - Phone:954-994-7456
Mailing Address - Fax:
Practice Address - Street 1:1152 N UNIVERSITY DR STE 201
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5152
Practice Address - Country:US
Practice Address - Phone:954-639-7345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9214871363LF0000X
FLAPRN9214871363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily