Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | ME59709 | FL |
NPI | 1053325118 |
---|---|
Provider Name | Celso E Pineiro |
First Address | Stuart, FL 34995-0417 |
Second Address | Port St Lucie, FL 34952-7564 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 30/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
054406000 | (05) | FL |
E88457 | (02) | FL |