Provider Demographics
NPI:1144273426
Name:VIERA, EDUARDO (MD)
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:VIERA
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 1:2455 SW 27TH AVE
Mailing Address - Street 2:#110
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3663
Mailing Address - Country:US
Mailing Address - Phone:305-285-8818
Mailing Address - Fax:305-285-1897
Practice Address - Street 1:1 GLEN ROYAL PKWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-5287
Practice Address - Country:US
Practice Address - Phone:855-226-6633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75836207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGF241AOtherMEDICARE GROUP PTAN
FLE1177TMedicare PIN
FLGF241AOtherMEDICARE GROUP PTAN