Healthcare Provider Details

I. General information

NPI: 1396731964
Provider Name (Legal Business Name): ALEJANDRA PEREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEJANDRA PEREZ MD

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 05/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 JOHNSON STREET
HOLLYWOOD FL
33021
US

IV. Provider business mailing address

PO BOX 862233
ORLANDO FL
32886-2233
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-6990
  • Fax: 954-965-6388
Mailing address:
  • Phone: 954-265-6990
  • Fax: 954-965-6388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number80220
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: