Provider Demographics
NPI:1356495998
Name:NANCY M REIERSON MD PA
Entity Type:Organization
Organization Name:NANCY M REIERSON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:REIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-669-3320
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBT-0017010430207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN NUMBER
FL=========OtherEIN NUMBER