MEDICARE: SOCRATES PEREZ-RODRIGUEZ 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
1	207R00000X	Internal Medicine Physician	ME86412	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215911011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOCRATES PEREZ-RODRIGUEZ MD

Provider Business Mailing Address
First Line	:	7211 155TH PL N
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418
Country	:	US
Telephone Number	:	561-746-4462
Fax Number	:

Provider Business Practice Location Address
First Line	:	1855 VETERANS PARK DR
Second Line	:	STE 103
City	:	NAPLES
State	:	FL
Zip	:	34109-0446
Country	:	US
Telephone Number	:	239-331-5114
Fax Number	:	239-631-5349

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	12/09/2015

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