MEDICARE: MRS. AYMAR MIZEI RODRIGUEZ-PEREZ M.D.

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	174400000X	Specialist	12808	PR
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	ME126430	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407863202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AYMAR MIZEI RODRIGUEZ-PEREZ M.D.

Provider Business Mailing Address
First Line	:	1573 W FAIRBANKS AVE STE 210
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-4679
Country	:	US
Telephone Number	:	407-646-7845
Fax Number	:

Provider Business Practice Location Address
First Line	:	1573 W FAIRBANKS AVE STE 210
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-4679
Country	:	US
Telephone Number	:	407-646-7845
Fax Number	:

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	02/07/2023

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