1306001490 NPI number — ALEXANDER G PEREZ MD PA

Table of content: (NPI 1306001490)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306001490 NPI number — ALEXANDER G PEREZ MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALEXANDER G PEREZ MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306001490
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14031 SW 20TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33175-7036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-788-0999
Provider Business Mailing Address Fax Number:
305-264-0253

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8720 N KENDALL DR
Provider Second Line Business Practice Location Address:
SUITE 211
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33176-2299
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-788-0999
Provider Business Practice Location Address Fax Number:
305-264-0253
Provider Enumeration Date:
07/28/2008

Additional Information

Authorized Official

Authorized Official Last Name:
PEREZ
Authorized Official First Name:
ALEXANDER
Authorized Official Middle Name:
G
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-788-0999

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  ME97580 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ME97580 . This is a "FLORIDA LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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