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NPI Code Detail

MEDICARE: FLORA IRENE PEREZ MSW, ASW

MEDICARE: FLORA IRENE PEREZ MSW, ASW
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1760602858
Entity Type Code : Individual
Provider Name (Legal Business Name) : FLORA IRENE PEREZ MSW, ASW
Provider Business Mailing Address
First Line : 1440 TOURS COURT
Second Line :
City : BEAUMONT
State : CA
Zip : 92223
Country : US
Telephone Number : 909-800-1699
Fax Number :
Provider Business Practice Location Address
First Line : 1330 W RAMSEY ST STE 100
Second Line :
City : BANNING
State : CA
Zip : 92220-4477
Country : US
Telephone Number : 951-849-7142
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2007
Last Update Date : 05/09/2009

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