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NPI Code Detail

MEDICARE: DR. RICARDO PERALES D.M.D.

MEDICARE:  DR. RICARDO  PERALES  D.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
1122300000XDentistDN 15473FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811173560
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICARDO PERALES D.M.D.
Provider Business Mailing Address
First Line : 10730 NW 66TH ST APT A-110
Second Line :
City : DORAL
State : FL
Zip : 33178-3706
Country : US
Telephone Number : 305-674-9324
Fax Number :
Provider Business Practice Location Address
First Line : 25 HOMESTEAD RD N STE 15
Second Line :
City : LEHIGH ACRES
State : FL
Zip : 33936-6600
Country : US
Telephone Number : 239-368-4997
Fax Number : 239-368-4996
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2008
Last Update Date : 01/11/2008

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Directions to “ DR. RICARDO PERALES D.M.D.” Practice Location

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