Basic Information
| Provider Information | |||||||||
| NPI: | 1306837778 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PINTO | ||||||||
| FirstName: | MARTIN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1357 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339021357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393320417 | ||||||||
| FaxNumber: | 2393349417 | ||||||||
| Practice Location | |||||||||
| Address1: | 2232 GRAND AVE | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339013717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393320417 | ||||||||
| FaxNumber: | 2393324701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ME78032 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.