Provider Demographics
NPI:1538125695
Name:PINEDA, LUIS F (MD, MSHA)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:F
Last Name:PINEDA
Suffix:
Gender:M
Credentials:MD, MSHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1834
Mailing Address - Country:US
Mailing Address - Phone:205-978-3570
Mailing Address - Fax:205-823-5086
Practice Address - Street 1:1909 LAUREL RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-1834
Practice Address - Country:US
Practice Address - Phone:205-978-3570
Practice Address - Fax:205-823-5086
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAP9400362174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510 33535OtherBCBS
AL529909970Medicaid
AL000033535Medicare ID - Type Unspecified
ALC78877Medicare UPIN