Healthcare Provider Details

I. General information

NPI: 1730368887
Provider Name (Legal Business Name): ALFRED PEREZ RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 NW 9TH AVE SUITE # 1311
MIAMI FL
33136-1409
US

IV. Provider business mailing address

6061 COLLINS AVE APT# 14-E
MIAMI BEACH FL
33140-2210
US

V. Phone/Fax

Practice location:
  • Phone: 305-355-7203
  • Fax: 305-355-7196
Mailing address:
  • Phone: 305-355-7203
  • Fax: 305-355-7196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License NumberPS 27522
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: