MEDICARE: PEDRO OLIVEIRA

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	225100000X	Physical Therapist	PT44055	FL

General Provider Information

NPI Number	:	1205790730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEDRO OLIVEIRA

Provider Business Mailing Address
First Line	:	21150 BISCAYNE BLVD STE 406
Second Line	:
City	:	AVENTURA
State	:	FL
Zip	:	33180-1250
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	360 GRANELLO AVE
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-1883
Country	:	US
Telephone Number	:	305-420-5682
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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Directions to “ PEDRO OLIVEIRA ” Practice Location

Language	Start Address	Practice Location

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