Provider Demographics
NPI:1093309148
Name:PEREIRA, LEANDRO
Entity Type:Individual
Prefix:
First Name:LEANDRO
Middle Name:
Last Name:PEREIRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 STARTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-9251
Mailing Address - Country:US
Mailing Address - Phone:407-412-8345
Mailing Address - Fax:
Practice Address - Street 1:3024 STARTOWN RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-9251
Practice Address - Country:US
Practice Address - Phone:407-412-8345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)