Pines, Jack A
Pines, Jack A is an individual health care provider with primary practice located at 2500 E Hallandale Beach Blvd Suite Ph-2, Hallandale Beach FL 33009-4834. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgical Oncology, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Pines, Jack A can be contacted via phone (954) 456-6500.Contact Information
Primary practice address
2500 E Hallandale Beach Blvd Suite Ph-2
Hallandale Beach FL 33009-4834
Phone: (954) 456-6500
Fax: (954) 456-6503
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgical Oncology | 2086X0206X | ME 48050 | Florida |
Allopathic & Osteopathic Physicians / Urology | 208800000X | ME48050 | Florida |
Profile Details
NPI number | 1285699447 |
---|---|
LBN Legal business name | Pines, Jack A |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 19th, 2006 |
Last updated | Apr 10th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1285699447 | NPPES |
Florida | Other | QMP000003703988 | MOLINA |
Florida | Other | 18645 | MOLINA |
Florida | Other | 4072125 | MOLINA |
Florida | Other | 77215 | MOLINA |
Florida | Other | P0003143 | MOLINA |
Florida | Other | P00470777 | MOLINA |
Florida | Other | 03807 | MOLINA |
Florida | Other | 11499 | MOLINA |
Florida | MEDICAID | 2730308 00 | MOLINA |
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