Healthcare Provider Details
I. General information
NPI: 1578664751
Provider Name (Legal Business Name): EUGENE G PEREIRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/26/2006
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2030 BEE RIDGE RD STE B
SARASOTA FL
34239-6108
US
IV. Provider business mailing address
7429 MONTE VERDE
SARASOTA FL
34238-4562
US
V. Phone/Fax
- Phone: 941-845-0233
- Fax: 941-538-6063
- Phone: 941-845-0233
- Fax: 941-538-6063
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | ME111784 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: