Provider Demographics
NPI:1326185430
Name:PINEIRO, ENRIQUE J (OD)
Entity Type:Individual
Prefix:DR
First Name:ENRIQUE
Middle Name:J
Last Name:PINEIRO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:ENRIQUE
Other - Middle Name:J
Other - Last Name:PINEIRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:220 KINGS POINT DR
Mailing Address - Street 2:601
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4775
Mailing Address - Country:US
Mailing Address - Phone:305-302-0643
Mailing Address - Fax:
Practice Address - Street 1:220 KINGS POINT DR
Practice Address - Street 2:601
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4775
Practice Address - Country:US
Practice Address - Phone:305-302-0643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPCO1174152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU49615Medicare UPIN
FL20480Medicare ID - Type Unspecified