Provider Demographics
NPI:1851615629
Name:JACK PARRINO MD PA
Entity Type:Organization
Organization Name:JACK PARRINO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-877-0550
Mailing Address - Street 1:5128 N HABANA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-6874
Mailing Address - Country:US
Mailing Address - Phone:813-877-0550
Mailing Address - Fax:
Practice Address - Street 1:5128 N HABANA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-6874
Practice Address - Country:US
Practice Address - Phone:813-877-0550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME29092207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD53896Medicare UPIN
FL30219Medicare PIN