Provider Demographics
NPI:1922045640
Name:MOUTINHO, MARIA E (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:MOUTINHO
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 1:4300 S BEACH PKWY APT 4103
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-8183
Mailing Address - Country:US
Mailing Address - Phone:412-736-3168
Mailing Address - Fax:
Practice Address - Street 1:4300 S BEACH PKWY APT 4103
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-8183
Practice Address - Country:US
Practice Address - Phone:412-736-3168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50962208000000X
PAMD421682208000000X
FLME94231208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics