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:
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Health care specialties

SpecialtyCodeLicense #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 9 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.

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Identifiers

StateTypeNumberIssuer
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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