Provider Demographics
NPI:1467849463
Name:URENA PAULINO, CHIRLYN (MD)
Entity Type:Individual
Prefix:
First Name:CHIRLYN
Middle Name:
Last Name:URENA PAULINO
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 1:1400 W STATE ROAD 434 STE 1010
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-3817
Mailing Address - Country:US
Mailing Address - Phone:407-644-9970
Mailing Address - Fax:407-644-6926
Practice Address - Street 1:1400 W STATE ROAD 434 STE 1010
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-3817
Practice Address - Country:US
Practice Address - Phone:407-644-9970
Practice Address - Fax:407-644-6926
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME135503208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024193900Medicaid