Healthcare Provider Details

I. General information

NPI: 1104492172
Provider Name (Legal Business Name): MICHAEL ERICSON PEREZ EKG TECH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 E FLAMINGO RD STE 311
LAS VEGAS NV
89121-5067
US

IV. Provider business mailing address

3430 E FLAMINGO RD STE 221
LAS VEGAS NV
89121-5065
US

V. Phone/Fax

Practice location:
  • Phone: 725-204-7591
  • Fax:
Mailing address:
  • Phone: 725-204-7591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: