Pine, Anthony Richard
Pine, Anthony Richard is an individual health care provider with primary practice located at 2776 Cleveland Ave , Fort Myers FL 33901-5855. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Pine, Anthony Richard can be contacted via phone (239) 343-2606.Contact Information
Primary practice address
2776 Cleveland Ave
Fort Myers FL 33901-5855
Phone: (239) 343-2606
Fax: (239) 343-3695
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA9101826 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA9101826 | Florida |
Profile Details
| NPI number | 1447234109 |
|---|---|
| LBN Legal business name | Pine, Anthony Richard |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 5th, 2005 |
| Last updated | Apr 5th, 2021 - about 5 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 | 1447234109 | NPPES |
| Florida | MEDICAID | 291154000 |
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