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General NPI Number Information
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NPI Number | 1205886033
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Entity Type | Individual
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Provider Name | ILEANA ROSARIO PEREZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 7000 SW 62ND AVE SUITE 200A
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4716
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Country | US
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Telephone | 305-662-9320
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Fax | 305-669-2111
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Provider Business Mailing Address
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Address Line | 7000 SW 62ND AVE SUITE 200A
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4716
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Country | US
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Telephone | 305-662-9320
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Fax | 305-669-2111
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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 | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | ME90778
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License Number State | FL
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