Basic Information
| Provider Information | |||||||||
| NPI: | 1376116988 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PINEDO MONES | ||||||||
| FirstName: | SHAKEIRA | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 TAMPA GENERAL CIR STE 240 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336063578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132583309 | ||||||||
| FaxNumber: | 8132514454 | ||||||||
| Practice Location | |||||||||
| Address1: | 5 TAMPA GENERAL CIR STE 240 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336063578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132583309 | ||||||||
| FaxNumber: | 8132514454 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2021 | ||||||||
| LastUpdateDate: | 04/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APRN11008594 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 111285000 | 05 | FL | MEDICAID | OSNIN | 01 | FL | BLUE CROSS BLUE SHIELD | OTHER |