Provider Demographics
NPI:1629017041
Name:DINELLI, DARIN LANCE (MD)
Entity Type:Individual
Prefix:DR
First Name:DARIN
Middle Name:LANCE
Last Name:DINELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4906 VIZCAYA DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-5900
Mailing Address - Country:US
Mailing Address - Phone:850-698-9523
Mailing Address - Fax:
Practice Address - Street 1:459 TURNER STREET B
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32508-0001
Practice Address - Country:US
Practice Address - Phone:850-452-5528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048110207Q00000X
FLME114152207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine