Healthcare Provider Details

I. General information

NPI: 1386723252
Provider Name (Legal Business Name): MIGUEL ANGEL PEREZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 02/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 E 25TH STREET SUITE 219
HIALEAH FL
33013-3850
US

IV. Provider business mailing address

PO BOX 140219
CORAL GABLES FL
33114-0219
US

V. Phone/Fax

Practice location:
  • Phone: 305-836-6805
  • Fax: 305-696-0856
Mailing address:
  • Phone: 305-836-6805
  • Fax: 305-696-0856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. MIGUEL A PEREZ
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 305-836-6805