MEDICARE: TIZIANA R PEREIRA SLP

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	235Z00000X	Speech-Language Pathologist	SA16939	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437668431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIZIANA R PEREIRA SLP

Provider Business Mailing Address
First Line	:	4703 GRAPEVINE WAY
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33331-3359
Country	:	US
Telephone Number	:	954-663-4530
Fax Number	:

Provider Business Practice Location Address
First Line	:	3335 N UNIVERSITY DR STE 5
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2230
Country	:	US
Telephone Number	:	954-442-9422
Fax Number	:	954-982-7724

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

Provider Enumeration Date	:	09/22/2017
Last Update Date	:	01/09/2025

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Directions to “ TIZIANA R PEREIRA SLP” Practice Location

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