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1890 State Road 436 Suite 255 Winter Park FL 32792-2285 | |
| (407) 657-7900 | |
| (407) 657-7942 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1890 State Road 436, Winter Park, Florida |
| Authorized Official Name and Position | Hal S Pineless (PRESIDENT) |
| Authorized Official Contact | 4076577900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1890 State Road 436 Suite 255 Winter Park FL 32792-2285 Ph: (407) 657-7900 | 1890 State Road 436 Suite 255 Winter Park FL 32792-2285 Ph: (407) 657-7900 |
| NPI Number | 1346230372 |
|---|---|
| Provider Enumeration Date | 10/21/2005 |
| Last Update Date | 11/10/2011 |
| Medicare PECOS PAC ID | 0345233417 |
|---|---|
| Medicare Enrollment ID | O20040405001471 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346230372 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | OS-0005087 (Florida) | Primary |
| Provider Name | Hal S Pineless |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114917978 PECOS PAC ID: 6608869797 Enrollment ID: I20090803000540 |
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