MEDICARE: MARLEN PEREZ RRT

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	227900000X	Registered Respiratory Therapist	RT13404	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	:	1629480488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLEN PEREZ RRT

Provider Business Mailing Address
First Line	:	3901 SW 109TH AVE
Second Line	:	APT F2
City	:	MIAMI
State	:	FL
Zip	:	33165-4438
Country	:	US
Telephone Number	:	786-516-7180
Fax Number	:	305-248-1009

Provider Business Practice Location Address
First Line	:	3901 SW 109TH AVE
Second Line	:	APT F2
City	:	MIAMI
State	:	FL
Zip	:	33165-4438
Country	:	US
Telephone Number	:	786-516-7180
Fax Number	:	305-248-1009

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

Provider Enumeration Date	:	05/28/2014
Last Update Date	:	05/28/2014

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Directions to “ MARLEN PEREZ RRT” Practice Location

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