Healthcare Provider Details

I. General information

NPI: 1053808113
Provider Name (Legal Business Name): RICK GENARO PEREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2018
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 SW 87TH AVE STE 104
MIAMI FL
33165-5472
US

IV. Provider business mailing address

4260 SW 153RD PL
MIAMI FL
33185-4297
US

V. Phone/Fax

Practice location:
  • Phone: 305-456-1766
  • Fax:
Mailing address:
  • Phone: 305-450-2429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number311586
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME147089
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME147089
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: