Healthcare Provider Details

I. General information

NPI: 1790908564
Provider Name (Legal Business Name): ALEXANDER G PEREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15055 NW 27TH AVE RM 138
OPA LOCKA FL
33054-3365
US

IV. Provider business mailing address

14031 SW 20TH ST
MIAMI FL
33175-7036
US

V. Phone/Fax

Practice location:
  • Phone: 786-466-2800
  • Fax:
Mailing address:
  • Phone: 305-613-0969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME 97580
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD 97580
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME 97580
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: