MEDICARE: ELLIOTT PEREZ

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	367H00000X	Anesthesiologist Assistant		WI

General Provider Information

NPI Number	:	1386506467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLIOTT PEREZ

Provider Business Mailing Address
First Line	:	9200 W WISCONSIN AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3522
Country	:	US
Telephone Number	:	414-805-8700
Fax Number	:

Provider Business Practice Location Address
First Line	:	9200 W WISCONSIN AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3522
Country	:	US
Telephone Number	:	414-805-8700
Fax Number	:

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

Provider Enumeration Date	:	11/26/2025
Last Update Date	:	01/16/2026

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Directions to “ ELLIOTT PEREZ ” Practice Location

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