MEDICARE: ELENA E 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	2080P0201X	Pediatric Allergy/Immunology Physician	ME103841	FL
2	207K00000X	Allergy & Immunology Physician	ME103841	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	29887	OTHER	FL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700805694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELENA E PEREZ M.D.

Provider Business Mailing Address
First Line	:	840 US HIGHWAY 1
Second Line	:	SUITE 235
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3830
Country	:	US
Telephone Number	:	561-626-2006
Fax Number	:	561-626-8622

Provider Business Practice Location Address
First Line	:	840 US HIGHWAY 1
Second Line	:	SUITE 235
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3830
Country	:	US
Telephone Number	:	561-626-2006
Fax Number	:	561-626-8622

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	02/17/2017

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Directions to “ ELENA E PEREZ M.D.” Practice Location

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