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General NPI Number Information
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NPI Number | 1265603591
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Entity Type | Organization
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Legal Business Name | GERIMED 2000 LLC
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Dates
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Enumeration Date | 03/14/2008
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Last Update Date | 04/13/2020
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Provider Practice Location Address
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Address Line | 5330 EHRLICH ROAD SUITE 138
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City | TAMPA
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State | FL
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Zip | 33624-6975
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Country | US
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Telephone | 803-908-5000
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Fax | 813-908-5030
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Provider Business Mailing Address
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Address Line | 5330 EHRLICH ROAD SUITE 138
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City | TAMPA
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State | FL
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Zip | 33624-6975
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Country | US
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Telephone | 803-908-5000
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Fax | 813-908-5030
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | DR. OSCAR PEREZ
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Credential | MD
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Telephone | 813-918-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | ME0061377
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License Number State | FL
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