MEDICARE: RENE PEREZ DO PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1053718866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENE PEREZ DO PA

Provider Business Mailing Address
First Line	:	145 MADEIRA AVE STE 205
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-4520
Country	:	US
Telephone Number	:	786-373-7975
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 MADEIRA AVE STE 205
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-4520
Country	:	US
Telephone Number	:	786-373-7975
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RENE PEREZ
Credential	:	DO
Telephone Number	:	786-373-7975

Provider Enumeration Date	:	11/21/2014
Last Update Date	:	11/21/2014

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Directions to “RENE PEREZ DO PA ” Practice Location

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