Healthcare Provider Details

I. General information

NPI: 1437724333
Provider Name (Legal Business Name): MARIA AMELIA PEROZO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 07/08/2024
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 LEE ST. 1215 LEE ST.
CHARLOTTESVILLE VA
22908-0816
US

IV. Provider business mailing address

1215 LEE ST. BOX 800225
CHARLOTTESVILLE VA
22908-0816
US

V. Phone/Fax

Practice location:
  • Phone: 434-924-2227
  • Fax: 434-243-7288
Mailing address:
  • Phone: 434-924-2227
  • Fax: 434-243-7288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: