Provider Demographics
NPI:1164495362
Name:PINON, AVELINO A (MD)
Entity Type:Individual
Prefix:
First Name:AVELINO
Middle Name:A
Last Name:PINON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 SW 87TH AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5458
Mailing Address - Country:US
Mailing Address - Phone:305-270-6000
Mailing Address - Fax:305-598-7754
Practice Address - Street 1:7400 SW 87TH AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5458
Practice Address - Country:US
Practice Address - Phone:305-270-6000
Practice Address - Fax:305-598-7754
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0049119174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002649600Medicaid
FLE75807Medicare UPIN
FL08715XMedicare PIN