Provider Demographics
NPI:1952482663
Name:PIMIENTA, VERONICA (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:PIMIENTA
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 1:2330 N ROSEMONT BLVD UNIT B
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2159
Mailing Address - Country:US
Mailing Address - Phone:520-323-2073
Mailing Address - Fax:520-323-1166
Practice Address - Street 1:2330 N ROSEMONT BLVD UNIT B
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2159
Practice Address - Country:US
Practice Address - Phone:520-323-2073
Practice Address - Fax:520-323-1166
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30541207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ717259Medicaid
AZZ77357Medicare PIN
AZZ166611Medicare PIN
H74794Medicare UPIN