Provider Demographics
NPI:1619644978
Name:PASQUALE REINO DO PC
Entity Type:Organization
Organization Name:PASQUALE REINO DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PASQUALE
Authorized Official - Middle Name:F
Authorized Official - Last Name:REINO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-761-5393
Mailing Address - Street 1:1391 RESOLUTE ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5318
Mailing Address - Country:US
Mailing Address - Phone:724-761-5393
Mailing Address - Fax:
Practice Address - Street 1:325 CYPRESS PKWY STE 200
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3326
Practice Address - Country:US
Practice Address - Phone:407-595-4389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1629275102OtherNPI- INDIVIDUAL
FLOS13982OtherMEDICAL LICENSE