Provider Demographics
NPI:1669771028
Name:PINEIRO, ALISHA FAYE (DO)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:FAYE
Last Name:PINEIRO
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 1:900 S PINE ISLAND RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3920
Mailing Address - Country:US
Mailing Address - Phone:727-376-4040
Mailing Address - Fax:727-376-8824
Practice Address - Street 1:10710 STATE ROAD 54
Practice Address - Street 2:SUITE 108
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-2263
Practice Address - Country:US
Practice Address - Phone:727-376-4040
Practice Address - Fax:727-376-8824
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11858208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010863200Medicaid