Provider Demographics
NPI:1992773493
Name:FERRON, PANSY (PA)
Entity type:Individual
Prefix:MS
First Name:PANSY
Middle Name:
Last Name:FERRON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13430 SW 96TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2207
Mailing Address - Country:US
Mailing Address - Phone:305-243-4598
Mailing Address - Fax:
Practice Address - Street 1:1400 NW 10TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1000
Practice Address - Country:US
Practice Address - Phone:305-243-4598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 000001933363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2914239-00Medicaid
FLE8587Medicare UPIN
FL2914239-00Medicaid