Provider Demographics
NPI:1346265105
Name:PIMENTEL, ELEONOR (MD)
Entity Type:Individual
Prefix:
First Name:ELEONOR
Middle Name:
Last Name:PIMENTEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 NW 132ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-1154
Mailing Address - Country:US
Mailing Address - Phone:305-559-9772
Mailing Address - Fax:
Practice Address - Street 1:747 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 408
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2049
Practice Address - Country:US
Practice Address - Phone:305-445-0700
Practice Address - Fax:305-447-1638
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0049570207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0049570OtherMEDICAL LICENSE
BP0700066OtherDEA CONTROLLED SUBSTANCE
FL02775Medicare ID - Type Unspecified
FLD50642Medicare UPIN