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General NPI Number Information
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NPI Number | 1760052849
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Entity Type | Organization
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Legal Business Name | DADE INTERNAL MEDICINE AND ASSOCIATES LLC
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 10/08/2022
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Provider Practice Location Address
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Address Line | 1801 NE 123RD ST STE 417
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2885
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Country | US
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Telephone | 786-534-4907
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Fax | 980-495-8939
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Provider Business Mailing Address
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Address Line | 811 NE 122ND ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5725
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Country | US
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Telephone | 305-962-2811
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. LUIS A PEREZ
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Credential | DO
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Telephone | 305-962-2811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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