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General NPI Number Information
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NPI Number | 1033537709
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Entity Type | Individual
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Provider Name | PAUL JOSE PERALES M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2014
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 4910 E 2ND AVE
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City | HIALEAH
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State | FL
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Zip | 33013-1410
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Country | US
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Telephone | 305-400-9454
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Fax |
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Provider Business Mailing Address
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Address Line | 4910 E 2ND AVE
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City | HIALEAH
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State | FL
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Zip | 33013-1410
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Country | US
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Telephone | 305-400-9454
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME141018
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License Number State | FL
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