Provider Demographics
NPI:1235178567
Name:PEREIRA, NELSON (MD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:
Last Name:PEREIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3191 CORAL WAY
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3213
Mailing Address - Country:US
Mailing Address - Phone:305-461-6060
Mailing Address - Fax:305-461-5911
Practice Address - Street 1:1301 LYONS RD
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33063-3900
Practice Address - Country:US
Practice Address - Phone:954-971-2266
Practice Address - Fax:305-461-5911
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0044944207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0044944OtherMEDICAL LICENSE
FLME0044944OtherMEDICAL LICENSE
FL14066OMedicare ID - Type Unspecified
FLBP2971934OtherDEA