MEDICARE: KATIUSKA PEREIRA ARNP

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	363LF0000X	Family Nurse Practitioner	APRN11001876	FL

General Provider Information

NPI Number	:	1770043879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIUSKA PEREIRA ARNP

Provider Business Mailing Address
First Line	:	718 W 36TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-5138
Country	:	US
Telephone Number	:	305-510-6414
Fax Number	:

Provider Business Practice Location Address
First Line	:	2406 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33305-2541
Country	:	US
Telephone Number	:	954-860-8687
Fax Number	:

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

Provider Enumeration Date	:	03/23/2019
Last Update Date	:	03/17/2020

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