MEDICARE: CARLOS ARMANDO PEREZ PA-C

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	363AM0700X	Medical Physician Assistant	11511	AZ

General Provider Information

NPI Number	:	1457245953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS ARMANDO PEREZ PA-C

Provider Business Mailing Address
First Line	:	3300 N 7TH AVE UNIT 505
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-4192
Country	:	US
Telephone Number	:	702-682-2169
Fax Number	:

Provider Business Practice Location Address
First Line	:	4350 N 19TH AVE STE 6
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-4602
Country	:	US
Telephone Number	:	602-264-9191
Fax Number	:	602-230-8486

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

Provider Enumeration Date	:	06/07/2025
Last Update Date	:	01/19/2026

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