Provider Demographics
NPI:1790972271
Name:S. JERRY PINTO, INC.
Entity Type:Organization
Organization Name:S. JERRY PINTO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIMMY
Authorized Official - Middle Name:JERRY
Authorized Official - Last Name:PINTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-960-6925
Mailing Address - Street 1:1269 FOXRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6427
Mailing Address - Country:US
Mailing Address - Phone:321-960-6925
Mailing Address - Fax:321-989-0246
Practice Address - Street 1:1269 FOXRIDGE PL
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-6427
Practice Address - Country:US
Practice Address - Phone:321-960-6925
Practice Address - Fax:321-989-0246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77004207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty