Provider Demographics
NPI:1770503229
Name:PINARD, MARGUERITE (MD)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:
Last Name:PINARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14505 BRUCE B DOWNS BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613
Mailing Address - Country:US
Mailing Address - Phone:813-971-5533
Mailing Address - Fax:813-910-7828
Practice Address - Street 1:14505 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613
Practice Address - Country:US
Practice Address - Phone:813-971-5533
Practice Address - Fax:813-910-7828
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME774462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257075100Medicaid
FL49660OtherBLUE CROSS BLUE SHIELD
FL257075100Medicaid
FL49660ZMedicare PIN
FL49660OtherBLUE CROSS BLUE SHIELD
FL49660Medicare PIN