Provider Demographics
NPI:1548004294
Name:MEYRELES PEREZ DE FERRERAS, PENELOPE PAOLA (DENTAL HYGIENIST)
Entity type:Individual
Prefix:
First Name:PENELOPE
Middle Name:PAOLA
Last Name:MEYRELES PEREZ DE FERRERAS
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13115 BOVET AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7660
Mailing Address - Country:US
Mailing Address - Phone:407-403-1299
Mailing Address - Fax:
Practice Address - Street 1:232 N ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-1612
Practice Address - Country:US
Practice Address - Phone:407-428-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30648124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist