MEDICARE: MANUEL RAMON PEREZ-IZQUIERDO 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	2086S0129X	Vascular Surgery Physician	ME77082	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	:	1942288808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANUEL RAMON PEREZ-IZQUIERDO MD

Provider Business Mailing Address
First Line	:	2415 N ORANGE AVE STE 302
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5505
Country	:	US
Telephone Number	:	407-303-7250
Fax Number	:	407-303-7255

Provider Business Practice Location Address
First Line	:	2415 N ORANGE AVE STE 302
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5505
Country	:	US
Telephone Number	:	407-303-7250
Fax Number	:	407-303-7255

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

Provider Enumeration Date	:	01/02/2006
Last Update Date	:	09/01/2020

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