Provider Demographics
NPI:1861934994
Name:PEREDA, ALEJANDRO ENRIQUE (DMD)
Entity type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:ENRIQUE
Last Name:PEREDA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8370 W FLAGLER ST STE 150
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2048
Mailing Address - Country:US
Mailing Address - Phone:305-227-3083
Mailing Address - Fax:
Practice Address - Street 1:8370 W FLAGLER ST STE 150
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2048
Practice Address - Country:US
Practice Address - Phone:305-227-3083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI026563001223E0200X
FLDN221751223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics