MEDICARE: LISA ANNE FERREIRA D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	OS8637	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083642243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA ANNE FERREIRA D.O.

Provider Business Mailing Address
First Line	:	5205 GREENWOOD AVE
Second Line	:	STE 251
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2400
Country	:	US
Telephone Number	:	561-844-6605
Fax Number	:	561-848-9059

Provider Business Practice Location Address
First Line	:	5205 GREENWOOD AVE
Second Line	:	STE 251
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2400
Country	:	US
Telephone Number	:	561-844-6605
Fax Number	:	561-848-9059

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	10/23/2018

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