Provider Demographics
NPI:1841162302
Name:PINNOCK, KEISHA-GAYE ALEXIA (APRN)
Entity type:Individual
Prefix:
First Name:KEISHA-GAYE
Middle Name:ALEXIA
Last Name:PINNOCK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:978 NW 126 TERRACE CORAL SPRINGS
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-4435
Mailing Address - Country:US
Mailing Address - Phone:954-504-3887
Mailing Address - Fax:
Practice Address - Street 1:978 NW 126TH TER
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-4435
Practice Address - Country:US
Practice Address - Phone:954-504-3887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11042078207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty