Provider Demographics
NPI:1154387033
Name:PEREIRA, DENISE L (MD)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:L
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 NW 12TH AVE
Mailing Address - Street 2:SUITE 3400
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1002
Mailing Address - Country:US
Mailing Address - Phone:305-243-9127
Mailing Address - Fax:305-243-9279
Practice Address - Street 1:1475 NW 12TH AVE
Practice Address - Street 2:SUITE 3400
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1002
Practice Address - Country:US
Practice Address - Phone:305-243-9127
Practice Address - Fax:305-243-9279
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88222207RH0000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2679060-00Medicaid
FLG55496Medicare UPIN
FL2679060-00Medicaid