Basic Information
Provider Information
NPI: 1104447036
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PINTO
FirstName: DENVER
MiddleName: STEVEN
NamePrefix: MR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1611 NW 12 AVENUE JACKSON MEMORIAL HOSPITAL
Address2: WEST WING 279 EMERGENCY RADIOLOGY
City: MIAMI
State: FL
PostalCode: 33136
CountryCode: US
TelephoneNumber: 3055858178
FaxNumber:  
Practice Location
Address1: 1611 NW 12 AVENUE JACKSON MEMORIAL HOSPITAL
Address2: WEST WING 279 EMERGENCY RADIOLOGY
City: MIAMI
State: FL
PostalCode: 33136
CountryCode: US
TelephoneNumber: 3055858178
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/01/2020
LastUpdateDate: 01/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate: 01/11/2022
NPIReactivationDate: 01/27/2022
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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