Provider Demographics
NPI:1881861805
Name:SAMUEL T PINOSKY MDPA
Entity Type:Organization
Organization Name:SAMUEL T PINOSKY MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:PINOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-263-2385
Mailing Address - Street 1:5150 TAMIAMI TRL N STE 201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-2818
Mailing Address - Country:US
Mailing Address - Phone:239-263-2385
Mailing Address - Fax:
Practice Address - Street 1:5150 TAMIAMI TRL N STE 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2818
Practice Address - Country:US
Practice Address - Phone:239-263-2385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00587542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7138OtherMEDICARE GROUP LEGACY