Provider Demographics
NPI:1518919117
Name:FERREIRA, ROBERT J (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:FERREIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 TRINITY OAKS BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4406
Mailing Address - Country:US
Mailing Address - Phone:727-645-6900
Mailing Address - Fax:727-372-8989
Practice Address - Street 1:2044 TRINITY OAKS BLVD STE 220
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-4406
Practice Address - Country:US
Practice Address - Phone:727-372-2501
Practice Address - Fax:813-635-2698
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71628207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL080134119OtherRAILROAD MEDICARE NUMBER
FL32674SOtherMEDICARE# - TRINITY OAKS FAMILY MEDICINE LLC
FL003621700Medicaid
FLP01746245OtherRR MCR # TRINITY OAKS FAMILY MEDICINE LLC
G42461Medicare UPIN
FL32674YMedicare PIN
FL32674TMedicare PIN