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General NPI Number Information
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NPI Number | 1508384157
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Entity Type | Individual
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Provider Name | ERIK ANTHONY PEREZ DPT, ATC
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Gender | Male
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Dates
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Enumeration Date | 09/05/2017
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 3713 GATWICK MANOR LN
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City | VIERA
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State | FL
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Zip | 32940-8412
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Country | US
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Telephone | 321-591-9831
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Fax |
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Provider Business Mailing Address
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Address Line | 1588 OCONNER AVENUE
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City | MELBOURNE
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State | FL
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Zip | 32940
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Country | US
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Telephone | 321-591-9831
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305211521
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 62868
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL2387
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT26869
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License Number State | FL
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