Provider Demographics
NPI:1245384882
Name:REIERSON, NANCY M (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:REIERSON
Suffix:
Gender:F
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:PO BOX 330157
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33233-0157
Mailing Address - Country:US
Mailing Address - Phone:305-669-3320
Mailing Address - Fax:305-669-3352
Practice Address - Street 1:5000 UNIVERSITY DR
Practice Address - Street 2:SUITE 301
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2008
Practice Address - Country:US
Practice Address - Phone:786-308-3000
Practice Address - Fax:786-308-3402
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 51632207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME51632OtherSTATE MEDICAL LICENSE
FL04896ZMedicare PIN
FLC81617Medicare UPIN