Individual
JOHANA PEREIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14254 DR MARTIN LUTHER KING JR BLVD, DOVER, FL 33527-4414
(813) 653-6100
(229) 436-4107
Mailing address
14254 DR MARTIN LUTHER KING JR BLVD, DOVER, FL 33527-4414
(813) 653-6100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN29471
FL
1223G0001X
General Practice Dentistry
Primary
DN29471
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/16/2022
Last updated
12/03/2024
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