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General NPI Number Information
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NPI Number | 1790096600
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Entity Type | Individual
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Provider Name | RENE PEREZ D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 1108 KANE CONCOURSE STE 302
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City | BAY HARBOR ISLANDS
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State | FL
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Zip | 33154-0049
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Country | US
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Telephone | 305-767-3748
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Fax |
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Provider Business Mailing Address
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Address Line | 12444 SW 197TH TER
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City | MIAMI
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State | FL
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Zip | 33177-4987
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Country | US
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Telephone | 786-373-7975
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | OS11485
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OS11485
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | OS11485
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS11485
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License Number State | FL
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