MEDICARE: CARLOS A PEREZ M.D.

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	207Q00000X	Family Medicine Physician	82456	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	:	1649289471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS A PEREZ M.D.

Provider Business Mailing Address
First Line	:	11805 SW 46TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-4739
Country	:	US
Telephone Number	:	305-610-2526
Fax Number	:	305-221-5224

Provider Business Practice Location Address
First Line	:	11805 SW 46TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-4739
Country	:	US
Telephone Number	:	305-610-2526
Fax Number	:	305-221-5224

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	12/06/2018

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Directions to “ CARLOS A PEREZ M.D.” Practice Location

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