MEDICARE: DR. BRYAN A. PEREZ DO

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	208100000X	Physical Medicine & Rehabilitation Physician	OS21639	FL

General Provider Information

NPI Number	:	1760057814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYAN A. PEREZ DO

Provider Business Mailing Address
First Line	:	PO BOX 22239
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-0001
Country	:	US
Telephone Number	:	702-899-0595
Fax Number	:	702-977-1496

Provider Business Practice Location Address
First Line	:	3601 LAKEWOOD BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34112-6145
Country	:	US
Telephone Number	:	872-231-3162
Fax Number	:

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

Provider Enumeration Date	:	05/21/2021
Last Update Date	:	11/13/2025

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