Healthcare Provider Details

I. General information

NPI: 1760848519
Provider Name (Legal Business Name): THIAGO FERRI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2016
Last Update Date: 01/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RUA RUI BARBOSA 650
FLORIANOPOLIS SANTA CATARINA
88025301
BR

IV. Provider business mailing address

RUA RUI BARBOSA 650
FLORIANOPOLIS SANTA CATARINA
88025301
BR

V. Phone/Fax

Practice location:
  • Phone: 554899779108
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number13905
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: