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NPI Code Detail

MEDICARE: JOSE V. PEREZ, D.O., P.A.

MEDICARE: JOSE V. PEREZ, D.O., P.A.
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
1207Q00000XFamily Medicine PhysicianOS10877FL

General Provider Information

NPI Number : 1336466457
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOSE V. PEREZ, D.O., P.A.
Provider Business Mailing Address
First Line : 4113 W 11TH LN
Second Line :
City : HIALEAH
State : FL
Zip : 33012-4164
Country : US
Telephone Number : 305-322-7582
Fax Number :
Provider Business Practice Location Address
First Line : 4751 W 4TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-3938
Country : US
Telephone Number : 305-456-8074
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOSE VICTOR PEREZ
Credential : D.O.
Telephone Number : 305-322-7582
Provider Enumeration Date : 04/28/2010
Last Update Date : 09/08/2010

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