Healthcare Provider Details

I. General information

NPI: 1790860625
Provider Name (Legal Business Name): HUGO PEREZ M.D. F.A.A.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 BONITA BEACH RD SE STE 106
BONITA SPRINGS FL
34135-4254
US

IV. Provider business mailing address

5955 PONCE DE LEON BLVD
CORAL GABLES FL
33146-2423
US

V. Phone/Fax

Practice location:
  • Phone: 239-213-0690
  • Fax: 239-552-4060
Mailing address:
  • Phone: 305-661-1515
  • Fax: 305-662-3723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME39502
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: