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General NPI Number Information
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NPI Number | 1861803041
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Entity Type | Organization
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Legal Business Name | LUIS M PEREZALONSO MD PA
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Dates
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Enumeration Date | 05/09/2014
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 2132 NW 129TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2581
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Country | US
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Telephone | 954-495-3252
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Fax | 954-241-3220
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Provider Business Mailing Address
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Address Line | 2132 NW 129TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2581
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Country | US
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Telephone | 954-495-3252
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Fax | 954-241-3220
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LUIS M PEREZALONSO
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Credential | MD
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Telephone | 954-495-3252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME109299
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License Number State | FL
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