MEDICARE: MIGUEL ANGEL PEREZ MD 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	2084P0804X	Child & Adolescent Psychiatry Physician		FL
2	207R00000X	Internal Medicine Physician		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

General Provider Information

NPI Number	:	1386723252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIGUEL ANGEL PEREZ MD PA

Provider Business Mailing Address
First Line	:	PO BOX 140219
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33114-0219
Country	:	US
Telephone Number	:	305-836-6805
Fax Number	:	305-696-0856

Provider Business Practice Location Address
First Line	:	777 E 25TH STREET
Second Line	:	SUITE 219
City	:	HIALEAH
State	:	FL
Zip	:	33013-3850
Country	:	US
Telephone Number	:	305-836-6805
Fax Number	:	305-696-0856

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	DR. MIGUEL A PEREZ
Credential	:	M.D.
Telephone Number	:	305-836-6805

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	02/17/2014

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