Provider Demographics
NPI:1437535218
Name:PEREIRA, PATRICIA NOBREGA RODRIGUES (DDS, PHD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:NOBREGA RODRIGUES
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:DDS, PHD
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 100415
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0415
Mailing Address - Country:US
Mailing Address - Phone:352-273-5850
Mailing Address - Fax:352-846-1643
Practice Address - Street 1:1395 CENTER DRIVE
Practice Address - Street 2:ROOM D9-6
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610
Practice Address - Country:US
Practice Address - Phone:352-273-5850
Practice Address - Fax:352-846-1643
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDTP6121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice