Healthcare Provider Details

I. General information

NPI: 1871729293
Provider Name (Legal Business Name): DR. JANET TOIRAC PERDOMO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 10/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 SW 87 AVENUE SUITE B260
MIAMI FL
33173-3570
US

IV. Provider business mailing address

7800 SW 87 AVENUE SUITE B260
MIAMI FL
33173-3570
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-4590
  • Fax: 305-279-2278
Mailing address:
  • Phone: 305-595-4590
  • Fax: 305-279-2278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME114168
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: