Healthcare Provider Details

I. General information

NPI: 1457674822
Provider Name (Legal Business Name): ALEJANDRO PEREZ D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2010
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 18TH ST STE 102
VERO BEACH FL
32960-0824
US

IV. Provider business mailing address

12350 NW 39TH ST STE 200
CORAL SPRINGS FL
33065-2414
US

V. Phone/Fax

Practice location:
  • Phone: 772-562-6818
  • Fax: 772-299-3653
Mailing address:
  • Phone: 954-248-3422
  • Fax: 800-970-6020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberOS11518
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: