Provider Demographics
NPI:1275675100
Name:VIRGILIO DEL PINO MD P A
Entity Type:Organization
Organization Name:VIRGILIO DEL PINO MD P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGILIO
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL PINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-235-1031
Mailing Address - Street 1:351 NW 42ND AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5670
Mailing Address - Country:US
Mailing Address - Phone:786-235-1031
Mailing Address - Fax:786-235-1033
Practice Address - Street 1:351 NW 42ND AVE STE 105
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5670
Practice Address - Country:US
Practice Address - Phone:786-235-1031
Practice Address - Fax:786-235-1033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87043207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267085200Medicaid