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General NPI Number Information
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NPI Number | 1134838931
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Entity Type | Individual
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Provider Name | SERGIO PERERA
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Gender | Male
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Dates
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Enumeration Date | 11/21/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 5100 CLARK RD
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City | SARASOTA
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State | FL
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Zip | 34233-3226
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Country | US
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Telephone | 941-926-8532
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Fax |
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Provider Business Mailing Address
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Address Line | 434 NE 15TH PL
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City | CAPE CORAL
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State | FL
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Zip | 33909-2161
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Country | US
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Telephone | 239-560-7576
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS65168
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License Number State | FL
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