Pine Enterprises, LLC
Point of Service in Clearwater, FL. Organization (NPI-2).
NPI number1174692685
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1174692685
- Entity type
- Organization (NPI-2)
- Legal business name
- Pine Enterprises, LLC
- Organization subpart
- No
- Enumeration date
- Nov 7, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305S00000X | Point of Service | – | – | Yes |
Practice location
407 N Belcher RdClearwater, FL 33765-2607
Phone 727-450-0700 · Fax 888-271-2833
Mailing address
407 N Belcher RdClearwater, FL 33765-2607
Phone 727-450-0700 · Fax 888-271-2833
Authorized official
Steven Grunebach
President
7274500700
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