Healthcare Provider Details

I. General information

NPI: 1306042908
Provider Name (Legal Business Name): ARNALDO ENRIQUE PEREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 N UNIVERSITY DR
PARKLAND FL
33067-1703
US

IV. Provider business mailing address

2240 QUAIL ROOST DR
WESTON FL
33327-1447
US

V. Phone/Fax

Practice location:
  • Phone: 954-518-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number17536
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number17536
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License Number17536
License Number StatePR
# 4
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number133607
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: