Healthcare Provider Details

I. General information

NPI: 1083642243
Provider Name (Legal Business Name): LISA ANNE FERREIRA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5205 GREENWOOD AVE STE 251
WEST PALM BEACH FL
33407-2400
US

IV. Provider business mailing address

5205 GREENWOOD AVE STE 251
WEST PALM BEACH FL
33407-2400
US

V. Phone/Fax

Practice location:
  • Phone: 561-844-6605
  • Fax: 561-848-9059
Mailing address:
  • Phone: 561-844-6605
  • Fax: 561-848-9059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS8637
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: