Provider Demographics
NPI:1295712909
Name:PINA-RODRIGUES, ESTELA (MD)
Entity type:Individual
Prefix:DR
First Name:ESTELA
Middle Name:
Last Name:PINA-RODRIGUES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA ESTERLINA
Other - Middle Name:NUNES
Other - Last Name:PINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M ESTELA N P RODR
Mailing Address - Street 1:3501 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5421
Mailing Address - Country:US
Mailing Address - Phone:954-265-5831
Mailing Address - Fax:
Practice Address - Street 1:3501 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5421
Practice Address - Country:US
Practice Address - Phone:336-832-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43015006512080N0001X
FLME912472080N0001X
NC2019-016122080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270814100Medicaid
MI1295712909Medicaid