MEDICARE: JOAN PEREZ AZCARIZ SA-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	246ZC0007X	Surgical Assistant	13-258	CO

General Provider Information

NPI Number	:	1508496571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN PEREZ AZCARIZ SA-C

Provider Business Mailing Address
First Line	:	2674 W 72ND PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-5434
Country	:	US
Telephone Number	:	786-202-6150
Fax Number	:

Provider Business Practice Location Address
First Line	:	2674 W 72ND PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-5434
Country	:	US
Telephone Number	:	786-202-6150
Fax Number	:

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

Provider Enumeration Date	:	01/18/2020
Last Update Date	:	01/18/2020

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Directions to “ JOAN PEREZ AZCARIZ SA-C” Practice Location

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