Healthcare Provider Details

I. General information

NPI: 1740277979
Provider Name (Legal Business Name): ISABEL ALTA GRACIA FERREIRA MD FAAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3441 SE WILLOUGHBY BLVD
STUART FL
34994-5060
US

IV. Provider business mailing address

5827 CORPORATE WAY
WEST PALM BEACH FL
33407-2000
US

V. Phone/Fax

Practice location:
  • Phone: 772-403-5650
  • Fax: 844-543-0397
Mailing address:
  • Phone: 561-844-9443
  • Fax: 561-472-9692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME57254
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: