Healthcare Provider Details

I. General information

NPI: 1124261359
Provider Name (Legal Business Name): CARA ELIZABETH PEREZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 04/19/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 REMICK BLVD
SPRINGBORO OH
45066-9168
US

IV. Provider business mailing address

54 REMICK BLVD STE 10
SPRINGBORO OH
45066-9168
US

V. Phone/Fax

Practice location:
  • Phone: 937-619-3616
  • Fax: 937-949-4870
Mailing address:
  • Phone: 937-619-3616
  • Fax: 937-949-4870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35081196
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number35.081196
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number35.081196
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: