Provider Demographics
NPI:1104129824
Name:FERREIROS, JOSE LUIS (PN)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:LUIS
Last Name:FERREIROS
Suffix:
Gender:M
Credentials:PN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17441 NW 82 CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015
Mailing Address - Country:US
Mailing Address - Phone:786-355-7381
Mailing Address - Fax:
Practice Address - Street 1:17441 NW 82ND CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3608
Practice Address - Country:US
Practice Address - Phone:786-355-7381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN1359201164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPN1359201OtherDEPARTMENT OF HEALTH