Individual
DR. JACK A PINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
ME 48050
FL
208800000X
Urology Physician
Primary
ME48050
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03807
BCBS FL
FL
01
—
11499
MEDICA
FL
01
—
18645
WELLCARE
FL
05
—
2730308 00
—
FL
01
—
4072125
AETNA PROVIDER #
FL
01
—
77215
MEDICARE GROUP
FL
01
—
P0003143
FLORIDA HEALTHCARE PLUS
FL
01
—
P00470777
RR MEDICARE
FL
01
—
QMP000003703988
MOLINA
FL
Enumeration date
04/19/2006
Last updated
04/10/2017
Update your record
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