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1821502162

NPI Code Detail

MEDICARE: ISMAEL PAVEL POLO PEREZ MD

MEDICARE: ISMAEL PAVEL POLO PEREZ MD

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	208M00000X	Hospitalist Physician	T6678	TX
2	207R00000X	Internal Medicine Physician	ME161829	FL
3	207R00000X	Internal Medicine Physician	T6678	TX
4	390200000X	Student in an Organized Health Care Education/Training Program
5	390200000X	Student in an Organized Health Care Education/Training Program	T6678	TX
6	246ZC0007X	Surgical Assistant	16-469	TX

General Provider Information

NPI Number	:	1821502162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISMAEL PAVEL POLO PEREZ MD

Provider Business Mailing Address
First Line	:	7150 INDIAN CREEK DR APT 202
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33141-3002
Country	:	US
Telephone Number	:	713-391-7800
Fax Number	:	678-487-5282

Provider Business Practice Location Address
First Line	:	1 BAYLOR PLZ
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-3411
Country	:	US
Telephone Number	:	713-798-4951
Fax Number	:

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

Provider Enumeration Date	:	11/22/2017
Last Update Date	:	03/14/2026

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Directions to “ ISMAEL PAVEL POLO PEREZ MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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