Provider Demographics
NPI:1952397762
Name:PEREIRA, REGINALD (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINALD
Middle Name:
Last Name:PEREIRA
Suffix:
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 1:8600 SW 92ND ST STE 204A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7377
Mailing Address - Country:US
Mailing Address - Phone:305-436-9933
Mailing Address - Fax:305-500-2137
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:2005-09-27
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59037207RP1001X
FLME0059037207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052181700Medicaid
FLA62194Medicare UPIN
FL11747ZMedicare PIN