Healthcare Provider Details

I. General information

NPI: 1952987463
Provider Name (Legal Business Name): GISELLE PEREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 JOHN F KENNEDY DR
ATLANTIS FL
33462-1119
US

IV. Provider business mailing address

101 JOHN F KENNEDY DR
ATLANTIS FL
33462-1119
US

V. Phone/Fax

Practice location:
  • Phone: 561-612-8080
  • Fax: 561-461-6211
Mailing address:
  • Phone: 561-612-8080
  • Fax: 561-612-8084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME165023
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: