Provider Demographics
NPI:1922035591
Name:FERRER, PETER L SR (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:L
Last Name:FERRER
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:PEDRO
Other - Middle Name:L
Other - Last Name:FERRER
Other - Suffix:SR
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 016960 (R-76)
Mailing Address - Street 2:UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33101
Mailing Address - Country:US
Mailing Address - Phone:305-585-6683
Mailing Address - Fax:305-324-6012
Practice Address - Street 1:1611 NW 12TH AVE STE 109
Practice Address - Street 2:JACKSON MEMORIAL HOSPITAL HOLTZ CHILDRENS HOSPITAL
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-585-6683
Practice Address - Fax:305-324-6012
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME217032080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0649724-00Medicaid
FL0649724-00Medicaid
FL91863Medicare UPIN