Organization
PINECREST PEDIATRICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORRAINE FUENTES MD (PRESIDENT)
(305) 819-8633
Entity
Organization
Contact information
Practice address
18590 NW 67TH AVE, SUITE # 101, HIALEAH, FL 33015-3306
(305) 819-8633
(305) 819-8630
Mailing address
PO BOX 566417, MIAMI, FL 33256-6417
(305) 819-8633
(305) 819-8630
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4648755
FL
Other
Enumeration date
10/13/2006
Last updated
08/22/2020
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