Provider Demographics
NPI:1811533060
Name:FERREIRA, LUIS
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:
Last Name:FERREIRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 SALZEDO ST STE 306
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5061
Mailing Address - Country:US
Mailing Address - Phone:305-521-7566
Mailing Address - Fax:
Practice Address - Street 1:2355 SALZEDO ST STE 306
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5061
Practice Address - Country:US
Practice Address - Phone:305-521-7566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF660-525-79-005-0172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver