Healthcare Provider Details

I. General information

NPI: 1043411010
Provider Name (Legal Business Name): MITCHELL PEREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11140 SW 88TH ST STE 200
MIAMI FL
33176-0901
US

IV. Provider business mailing address

20211 SW 92ND AVE
MIAMI FL
33189-1810
US

V. Phone/Fax

Practice location:
  • Phone: 302-271-3223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT23278
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: