Individual
EDGARD L PEREIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17387 BALARIA ST, BOCA RATON, FL 33496-3279
(561) 312-0057
(954) 239-3902
Mailing address
17387 BALARIA ST, BOCA RATON, FL 33496-3279
(561) 312-0057
(954) 239-3902
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
36956
KY
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME104596
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000507978
ANTHEM FOR NORTON
KY
01
—
146SM
BCBS
FL
05
—
200376030
—
IN
01
—
2806906000
PAD FOR NORTON
KY
01
—
50013581
PASSPORT FOR NORTON
KY
05
—
64049190
—
KY
01
—
CS337Z
MEDICARE PTAN
FL
01
—
P00439749
RRMCR FOR NORTON
KY
Enumeration date
06/13/2005
Last updated
06/27/2024
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