MEDICARE: OXANA PEREIRA

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	225200000X	Physical Therapy Assistant	PTA26200	FL

General Provider Information

NPI Number	:	1477913440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OXANA PEREIRA

Provider Business Mailing Address
First Line	:	420 W 17TH ST APT 7
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-2401
Country	:	US
Telephone Number	:	786-970-0853
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 W 17TH ST APT 7
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-2401
Country	:	US
Telephone Number	:	786-970-0853
Fax Number	:

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

Provider Enumeration Date	:	03/03/2016
Last Update Date	:	03/03/2016

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Directions to “ OXANA PEREIRA ” Practice Location

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