Basic Information
Provider Information
NPI: 1871987446
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EPERJESIOVA
FirstName: BIANKA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1601 SW ARCHER RD
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326081135
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1601 SW ARCHER RD
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326081135
CountryCode: US
TelephoneNumber: 3523761611
FaxNumber: 2488495324
Other Information
ProviderEnumerationDate: 03/22/2015
LastUpdateDate: 09/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X125067766ILY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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