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General NPI Number Information
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NPI Number | 1427206739
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Entity Type | Organization
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Legal Business Name | SUNCOAST PREMIER MEDICAL LLC
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Dates
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Enumeration Date | 08/29/2008
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 40107 HIGHWAY 27 FL 2
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City | DAVENPORT
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State | FL
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Zip | 33837-5901
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Country | US
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Telephone | 352-243-3555
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Fax | 352-243-6614
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Provider Business Mailing Address
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Address Line | 40107 HIGHWAY 27 FL 2
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City | DAVENPORT
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State | FL
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Zip | 33837-5901
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Country | US
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Telephone | 352-243-3555
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Fax | 352-243-6614
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Authorized Official
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Title or Position | OWNER
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Name | MARIO RENE PEREZ
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Credential | M.D.
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Telephone | 863-207-6554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME72969
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License Number State | FL
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