Healthcare Provider Details
I. General information
NPI: 1013959246
Provider Name (Legal Business Name): JOSE PEREZ-TIRSE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/12/2006
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8200 SW 117TH AVE STE 208
MIAMI FL
33183-4825
US
IV. Provider business mailing address
8200 SW 117TH AVE STE 208
MIAMI FL
33183-4825
US
V. Phone/Fax
- Phone: 786-973-5524
- Fax: 305-226-8826
- Phone: 786-973-5524
- Fax: 305-226-8826
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | ME63851 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: