Provider Demographics
NPI:1699157313
Name:PEREIRA, JOSE FRANCISCO (NP)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:FRANCISCO
Last Name:PEREIRA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:FRANK
Other - Middle Name:
Other - Last Name:PEREIRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:6255 W SUNSET BLVD FL 21
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7422
Mailing Address - Country:US
Mailing Address - Phone:323-860-5200
Mailing Address - Fax:323-467-7119
Practice Address - Street 1:1701 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1851
Practice Address - Country:US
Practice Address - Phone:407-204-7000
Practice Address - Fax:407-204-7001
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9367959363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY 0 T 4 9OtherFLORIDA BLUE
FL13582758OtherCAQH
FL015898800Medicaid