Provider Demographics
NPI:1710711759
Name:IGLESIAS PEREIRA, MILAN
Entity type:Individual
Prefix:
First Name:MILAN
Middle Name:
Last Name:IGLESIAS PEREIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1778 PIERSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-8035
Mailing Address - Country:US
Mailing Address - Phone:561-334-1099
Mailing Address - Fax:
Practice Address - Street 1:3476 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-2000
Practice Address - Country:US
Practice Address - Phone:954-475-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant