MEDICARE: DR. LEONEL PEREZ-LIMONTE MD, MS-HQPS, MHL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0008X	Neuromuscular Medicine (Psychiatry & Neurology) Physician	MD-2012-0661	FL
2	2084N0400X	Neurology Physician	ME0054686	FL
3	2084P0301X	Brain Injury Medicine (Psychiatry & Neurology) Physician	ME0054686	FL
4	2084N0400X	Neurology Physician	MD-2012-0661	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	09761	OTHER	FL	BCBS
2	592157762	OTHER	FL	TAX I.D. NUMBER

General Provider Information

NPI Number	:	1063420412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONEL PEREZ-LIMONTE MD, MS-HQPS, MHL

Provider Business Mailing Address
First Line	:	1750 LENOX AVE
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2415
Country	:	US
Telephone Number	:	305-495-6503
Fax Number	:

Provider Business Practice Location Address
First Line	:	2420 W PIERCE ST STE 101
Second Line	:
City	:	CARLSBAD
State	:	NM
Zip	:	88220-3517
Country	:	US
Telephone Number	:	575-628-0107
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	05/03/2024

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