Provider Demographics
NPI:1477880821
Name:WILBERT B PINO PA
Entity Type:Organization
Organization Name:WILBERT B PINO PA
Other - Org Name:ORTHOPAEDIC SPINE & FRACTURE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-317-2877
Mailing Address - Street 1:PO BOX 212487
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33421-2487
Mailing Address - Country:US
Mailing Address - Phone:561-296-2345
Mailing Address - Fax:561-296-2346
Practice Address - Street 1:5700 LAKE WORTH RD
Practice Address - Street 2:SUITE 103
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-4727
Practice Address - Country:US
Practice Address - Phone:561-296-2345
Practice Address - Fax:561-296-2346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty