Provider Demographics
NPI:1245449487
Name:DEL PINO-WHITE, PERLA (DO)
Entity type:Individual
Prefix:
First Name:PERLA
Middle Name:
Last Name:DEL PINO-WHITE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 NE 3RD ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-1046
Mailing Address - Country:US
Mailing Address - Phone:754-206-2420
Mailing Address - Fax:954-333-2413
Practice Address - Street 1:105 NE 3RD ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-1046
Practice Address - Country:US
Practice Address - Phone:754-206-2420
Practice Address - Fax:954-333-2413
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine