Provider Demographics
NPI:1710744321
Name:SIMPLYMADE MEDICINE LLC
Entity Type:Organization
Organization Name:SIMPLYMADE MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PINOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:903-330-9131
Mailing Address - Street 1:1785 N ANDREWS SQ APT 209E
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311-4844
Mailing Address - Country:US
Mailing Address - Phone:903-330-9131
Mailing Address - Fax:
Practice Address - Street 1:1785 N ANDREWS SQ APT 209E
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-4844
Practice Address - Country:US
Practice Address - Phone:903-330-9131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty