MEDICARE: DR. MARIA ROSA PEREZ HERNANDEZ DC

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	111N00000X	Chiropractor	14616	FL

General Provider Information

NPI Number	:	1417723115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA ROSA PEREZ HERNANDEZ DC

Provider Business Mailing Address
First Line	:	3542 SANTA FE PL
Second Line	:
City	:	COCONUT CREEK
State	:	FL
Zip	:	33073-2251
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5801 S DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-3651
Country	:	US
Telephone Number	:	561-594-0150
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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