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NPI Code Detail

MEDICARE: JOSE GEORGE PERALES VILLARROEL MD

MEDICARE: JOSE GEORGE PERALES VILLARROEL MD
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
1390200000XStudent in an Organized Health Care Education/Training Program38917FL

General Provider Information

NPI Number : 1144097858
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE GEORGE PERALES VILLARROEL MD
Provider Business Mailing Address
First Line : 1337 W 49TH PL APT 305
Second Line :
City : HIALEAH
State : FL
Zip : 33012-3122
Country : US
Telephone Number : 954-451-4712
Fax Number :
Provider Business Practice Location Address
First Line : 1475 W 49TH PL
Second Line :
City : HIALEAH
State : FL
Zip : 33012-3113
Country : US
Telephone Number : 305-558-2500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2023
Last Update Date : 12/04/2023

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