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General NPI Number Information
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NPI Number | 1730069816
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Entity Type | Individual
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Provider Name | LEONARDO PEREZ JR. MS, RDN, CD
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Gender | Male
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 909 E MICHIGAN ST UNIT 3905
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City | MILWAUKEE
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State | WI
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Zip | 53202-5661
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Country | US
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Telephone | 414-406-3335
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Fax |
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Provider Business Mailing Address
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Address Line | 909 E MICHIGAN ST UNIT 3905
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City | MILWAUKEE
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State | WI
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Zip | 53202-5661
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Country | US
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Telephone | 414-406-3335
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 6576-29
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 3377
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | LD-D-10261889
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License Number State | OR
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