MEDICARE: CARLINDO DA REITZ PEREIRA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	60122633	WA
2	207W00000X	Ophthalmology Physician	A76921	CA
3	207W00000X	Ophthalmology Physician	01066189A	IN

General Provider Information

NPI Number	:	1003917402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLINDO DA REITZ PEREIRA M.D.

Provider Business Mailing Address
First Line	:	2100 LITTLE MOUNTAIN LN
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98274-8752
Country	:	US
Telephone Number	:	360-416-6735
Fax Number	:	360-424-6954

Provider Business Practice Location Address
First Line	:	2100 LITTLE MOUNTAIN LN
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98274-8752
Country	:	US
Telephone Number	:	360-416-6735
Fax Number	:	360-424-6954

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	12/02/2020

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Directions to “ CARLINDO DA REITZ PEREIRA M.D.” Practice Location

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