Healthcare Provider Details

I. General information

NPI: 1740516681
Provider Name (Legal Business Name): SOCRATES PEREZ RODRIGUEZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2009
Last Update Date: 07/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 VETERANS PARK DR SUITE 103
NAPLES FL
34109-0446
US

IV. Provider business mailing address

1855 VETERANS PARK DR SUITE 103
NAPLES FL
34109-0446
US

V. Phone/Fax

Practice location:
  • Phone: 239-331-5114
  • Fax:
Mailing address:
  • Phone: 239-331-5114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SOCRATES PEREZ RODRIGUEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 561-315-1940