Provider Demographics
NPI:1639527807
Name:PINEDA TORRES, JUAN SR
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:PINEDA TORRES
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14750 SW 26TH ST STE 111
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5935
Mailing Address - Country:US
Mailing Address - Phone:786-703-7180
Mailing Address - Fax:786-762-2697
Practice Address - Street 1:14750 SW 26TH ST STE 111
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5935
Practice Address - Country:US
Practice Address - Phone:786-703-7180
Practice Address - Fax:786-762-2697
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-28
Last Update Date:2016-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator