Provider Demographics
NPI:1922326198
Name:PINNACLE MEDICAL INSTITUTE
Entity Type:Organization
Organization Name:PINNACLE MEDICAL INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:EDISON
Authorized Official - Middle Name:
Authorized Official - Last Name:ALOMIA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:954-239-4596
Mailing Address - Street 1:3700 WASHINGTON ST STE 500
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8259
Mailing Address - Country:US
Mailing Address - Phone:954-239-4596
Mailing Address - Fax:954-239-4599
Practice Address - Street 1:3700 WASHINGTON ST STE 500
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8259
Practice Address - Country:US
Practice Address - Phone:954-239-4596
Practice Address - Fax:954-239-4599
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINNACLE HEALTHCARE SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001609700Medicaid
FLBA500OtherPTAN