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General NPI Number Information
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NPI Number | 1487835922
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Entity Type | Organization
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Legal Business Name | LISA PEREZ-GROSSMAN, M.D., P.A.
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 1235 SW 87TH AVE
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City | MIAMI
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State | FL
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Zip | 33174-3306
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Country | US
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Telephone | 305-269-1990
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Fax | 305-269-1970
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Provider Business Mailing Address
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Address Line | 1235 SW 87TH AVE
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City | MIAMI
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State | FL
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Zip | 33174-3306
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Country | US
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Telephone | 305-269-1990
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Fax | 305-269-1970
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Authorized Official
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Title or Position | DR.
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Name | DR. LISA MARIA PEREZ-GROSSMAN
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Credential | M.D.
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Telephone | 305-269-1990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME0071327
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License Number State | FL
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