MEDICARE: BRENDEN P. PERAZA R.T.

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	2085R0202X	Diagnostic Radiology Physician	1066617	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NA	OTHER	FL	NA

General Provider Information

NPI Number	:	1881530988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDEN P. PERAZA R.T.

Provider Business Mailing Address
First Line	:	3662 SW 59TH TER
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33314-2618
Country	:	US
Telephone Number	:	201-758-6810
Fax Number	:

Provider Business Practice Location Address
First Line	:	3662 SW 59TH TER
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33314-2618
Country	:	US
Telephone Number	:	201-758-6810
Fax Number	:

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

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	04/28/2026

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