Healthcare Provider Details

I. General information

NPI: 1073145686
Provider Name (Legal Business Name): ROSA VICTORIA PEREIRA DA SILVA PSYD,LMFT,CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROSA PEREIRA PSYD,LMFT,CHT

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17900 NW 5TH ST STE 103
PEMBROKE PINES FL
33029-2809
US

IV. Provider business mailing address

17900 NW 5TH ST STE 103
PEMBROKE PINES FL
33029-2809
US

V. Phone/Fax

Practice location:
  • Phone: 954-388-0800
  • Fax: 954-645-7755
Mailing address:
  • Phone: 954-388-0800
  • Fax: 954-645-7755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMT4670
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT4670
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: