Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 36115058 | IL |
NPI | 1003818188 |
---|---|
Provider Name | Dr. Ronnie Pimentel |
First Address | Weston, FL 33331 |
Second Address | Weston, FL 33331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2005 |
Last Update Date | 14/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
K27162 | (02) | IL |