=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386819274
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARTURO PEREZ MD, CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/23/2008
-----------------------------------------------------
Last Update Date | 04/23/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8390 W FLAGLER ST SUITE 202
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33144-2039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-207-9401
-----------------------------------------------------
Fax | 305-207-9402
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8390 W FLAGLER ST SUITE 202
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33144-2039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-207-9401
-----------------------------------------------------
Fax | 305-207-9402
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | NERY MANZANO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-207-9401
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | ME 18355
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------