Healthcare Provider Details

I. General information

NPI: 1649229758
Provider Name (Legal Business Name): CHRISTIAN A PERZANOWSKI-OBREGON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CHRISTIAN A PERZANOWSKI M.D.

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 EICHENFELD DR
BRANDON FL
33511-5908
US

IV. Provider business mailing address

635 EICHENFELD DR
BRANDON FL
33511-5908
US

V. Phone/Fax

Practice location:
  • Phone: 813-684-6000
  • Fax: 813-654-9032
Mailing address:
  • Phone: 813-684-6000
  • Fax: 813-654-9032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME 95425
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: