MEDICARE: JAIME PEREZ M.D., P.A.

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	208200000X	Plastic Surgery Physician

General Provider Information

NPI Number	:	1124268339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAIME PEREZ M.D., P.A.

Provider Business Mailing Address
First Line	:	307 S MACDILL AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3141
Country	:	US
Telephone Number	:	813-877-3739
Fax Number	:	813-877-3738

Provider Business Practice Location Address
First Line	:	307 S MACDILL AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3141
Country	:	US
Telephone Number	:	813-877-3739
Fax Number	:	813-877-3738

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAIME PEREZ
Credential	:	M.D.
Telephone Number	:	813-877-3739

Provider Enumeration Date	:	02/27/2009
Last Update Date	:	02/27/2009

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