MEDICARE: DR. ANN MARIE PEREIRA D.D.S

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	1223P0700X	Prosthodontics	DN21565	FL

General Provider Information

NPI Number	:	1619325453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANN MARIE PEREIRA D.D.S

Provider Business Mailing Address
First Line	:	701 BRICKELL KEY BLVD
Second Line	:	APT #1711
City	:	MIAMI
State	:	FL
Zip	:	33131-2674
Country	:	US
Telephone Number	:	352-359-4446
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 BRICKELL KEY BLVD
Second Line	:	APT #1711
City	:	MIAMI
State	:	FL
Zip	:	33131-2674
Country	:	US
Telephone Number	:	352-359-4446
Fax Number	:

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

Provider Enumeration Date	:	06/02/2016
Last Update Date	:	06/02/2016

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