MEDICARE: DR. RICARDO A PEREZ MD

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	207R00000X	Internal Medicine Physician	ME85720	FL
2	208M00000X	Hospitalist Physician	ME85720	FL
3	207R00000X	Internal Medicine Physician	MD433094	PA

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
2	160095	OTHER	FL	PREFERRED CARE
3	51427	OTHER	FL	BCBS
4	608025500	OTHER	FL	BLACK LUNG FED PROGRAM

General Provider Information

NPI Number	:	1669467957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICARDO A PEREZ MD

Provider Business Mailing Address
First Line	:	409 S 2ND ST STE 2F
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17104-1612
Country	:	US
Telephone Number	:	717-231-8968
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 INNOVATION DR
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17408-8815
Country	:	US
Telephone Number	:	717-843-8623
Fax Number	:	717-815-2489

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	08/15/2019

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