Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 21700 | FL |
NPI | 1013279769 |
---|---|
Provider Name | Dr. Rosario Mairym Pinero Correa I |
First Address | Palm Beach Gardens, FL 33410-3224 |
Second Address | Palm Beach Gardens, FL 33410-3224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2012 |
Last Update Date | 11/05/2017 |