Provider Demographics
NPI:1679967657
Name:PEREIRA, REGINALD JR (MD)
Entity Type:Individual
Prefix:MR
First Name:REGINALD
Middle Name:
Last Name:PEREIRA
Suffix:JR
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 1:198 NW 37TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4826
Mailing Address - Country:US
Mailing Address - Phone:305-267-5544
Mailing Address - Fax:305-500-2133
Practice Address - Street 1:198 NW 37TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4826
Practice Address - Country:US
Practice Address - Phone:305-267-5544
Practice Address - Fax:305-500-2133
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY297686390200000X
FLME136598207RP1001X, 207RC0200X, 207R00000X
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine