MEDICARE: ELVIS PEREZ

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	367500000X	Certified Registered Nurse Anesthetist	1086308	TX
2	367500000X	Certified Registered Nurse Anesthetist	11019847	FL

General Provider Information

NPI Number	:	1689203556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELVIS PEREZ

Provider Business Mailing Address
First Line	:	19894 SW 3RD PL
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-1250
Country	:	US
Telephone Number	:	305-310-9663
Fax Number	:

Provider Business Practice Location Address
First Line	:	19894 SW 3RD PL
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-1250
Country	:	US
Telephone Number	:	305-310-9663
Fax Number	:

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

Provider Enumeration Date	:	04/03/2020
Last Update Date	:	03/18/2026

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Directions to “ ELVIS PEREZ ” Practice Location

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