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General NPI Number Information
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NPI Number | 1932178308
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Entity Type | Individual
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Provider Name | RUBEN EDGARDO PEREZ MD
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 09/26/2019
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Provider Practice Location Address
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Address Line | 350 1ST ST N
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City | WINTER HAVEN
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State | FL
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Zip | 33881-4113
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Country | US
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Telephone | 863-595-4130
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Fax | 863-595-0459
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Provider Business Mailing Address
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Address Line | 350 1ST ST N
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City | WINTER HAVEN
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State | FL
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Zip | 33881-4113
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Country | US
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Telephone | 863-595-4130
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Fax | 863-595-0459
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME70231
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License Number State | FL
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