Healthcare Provider Details

I. General information

NPI: 1962701599
Provider Name (Legal Business Name): JORGE FRANCISCO PEREIRA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 06/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4302 ALTON RD STE 540
MIAMI BEACH FL
33140
US

IV. Provider business mailing address

4302 ALTON RD STE 540
MIAMI BEACH FL
33140-2842
US

V. Phone/Fax

Practice location:
  • Phone: 305-674-2499
  • Fax: 305-674-2899
Mailing address:
  • Phone: 305-674-2499
  • Fax: 305-674-2899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME135223
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: