Provider Demographics
NPI:1174337141
Name:PINIELLA, ANICA LUCILLE
Entity type:Individual
Prefix:
First Name:ANICA
Middle Name:LUCILLE
Last Name:PINIELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14814 LAKE MAGDALENE CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1710
Mailing Address - Country:US
Mailing Address - Phone:813-240-1702
Mailing Address - Fax:
Practice Address - Street 1:14814 LAKE MAGDALENE CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1710
Practice Address - Country:US
Practice Address - Phone:813-240-1702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program