Healthcare Provider Details

I. General information

NPI: 1285159178
Provider Name (Legal Business Name): BELKIS PEREZ O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2017
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11402 NW 41ST ST STE 121
DORAL FL
33178-4862
US

IV. Provider business mailing address

11402 NW 41ST ST STE 121
DORAL FL
33178-4862
US

V. Phone/Fax

Practice location:
  • Phone: 305-239-5890
  • Fax: 305-315-3359
Mailing address:
  • Phone: 305-239-5890
  • Fax: 305-315-3359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC5250
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: