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General NPI Number Information
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NPI Number | 1245849645
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Entity Type | Individual
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Provider Name | SHANNON PEREIRA NP
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Gender | Female
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Dates
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Enumeration Date | 07/31/2020
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 5530 NORTHROP RD
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City | MILTON
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State | FL
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Zip | 32570-8701
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Country | US
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Telephone | 910-742-9243
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Fax |
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Provider Business Mailing Address
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Address Line | 9448 CHANNING HILL DR
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-0249
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Country | US
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Telephone | 401-662-7740
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Fax | 401-340-1813
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 95015078
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11021105
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License Number State | FL
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