Healthcare Provider Details

I. General information

NPI: 1306001490
Provider Name (Legal Business Name): ALEXANDER G PEREZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 03/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8720 N KENDALL DR SUITE 211
MIAMI FL
33176-2299
US

IV. Provider business mailing address

14031 SW 20TH ST
MIAMI FL
33175-7036
US

V. Phone/Fax

Practice location:
  • Phone: 305-788-0999
  • Fax: 305-264-0253
Mailing address:
  • Phone: 305-788-0999
  • Fax: 305-264-0253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME97580
License Number StateFL

VIII. Authorized Official

Name: DR. ALEXANDER G PEREZ
Title or Position: PRESIDENT
Credential: MD
Phone: 305-788-0999