Provider Demographics
NPI:1780200840
Name:PINNOCK, SAFA NESTAGIA
Entity Type:Individual
Prefix:
First Name:SAFA
Middle Name:NESTAGIA
Last Name:PINNOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 27TH AVE SW
Mailing Address - Street 2:SUITE 9 & 10
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32968
Mailing Address - Country:US
Mailing Address - Phone:772-257-5264
Mailing Address - Fax:
Practice Address - Street 1:755 27TH AVE SW
Practice Address - Street 2:SUITE 9 & 10
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32968
Practice Address - Country:US
Practice Address - Phone:772-257-5264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator