Provider Demographics
NPI:1992103444
Name:FERREIRO, LISSETTE MARIA
Entity type:Individual
Prefix:MRS
First Name:LISSETTE
Middle Name:MARIA
Last Name:FERREIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LISSETTE
Other - Middle Name:MARIA
Other - Last Name:FERREIRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:11348 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1120
Mailing Address - Country:US
Mailing Address - Phone:786-683-0517
Mailing Address - Fax:
Practice Address - Street 1:2223 SW 13TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3920
Practice Address - Country:US
Practice Address - Phone:305-854-7377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 47360183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist