Provider Demographics
NPI:1740504794
Name:PEREIRA, ELZA MARIA (DMD)
Entity type:Individual
Prefix:
First Name:ELZA
Middle Name:MARIA
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 MERIDIAN AVENUE
Mailing Address - Street 2:#2
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139
Mailing Address - Country:US
Mailing Address - Phone:973-270-4611
Mailing Address - Fax:
Practice Address - Street 1:660 NORTH STATE ROAD 7
Practice Address - Street 2:#12
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317
Practice Address - Country:US
Practice Address - Phone:954-583-4447
Practice Address - Fax:954-583-8641
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17445122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist