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General NPI Number Information
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NPI Number | 1437102654
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Entity Type | Individual
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Provider Name | ANDRES M PEREZ DPM
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 15805 SHADDOCK DR STE B
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City | WINTER GARDEN
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State | FL
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Zip | 34787-5769
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Country | US
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Telephone | 407-423-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 3165 MCCRORY PL SUITE 174
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City | ORLANDO
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State | FL
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Zip | 32803-3771
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Country | US
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Telephone | 407-423-1234
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Fax | 407-517-1040
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 3234
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License Number State | FL
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