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General NPI Number Information
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NPI Number | 1134541444
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Entity Type | Individual
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Provider Name | GUILLERMO PEREZ III MD
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Gender | Male
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Dates
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Enumeration Date | 01/07/2014
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | USS SAN ANTONIO (LPD 17)
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City | NORFOLK
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State | VA
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Zip | 23511
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Country | US
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Telephone | 757-322-2366
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Fax |
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Provider Business Mailing Address
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Address Line | UNIT 100326 BOX 1
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City | FPO
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State | AE
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Zip | 09587-2600
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101258722
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License Number State | VA
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