MEDICARE: MS. VIVIANA 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	208D00000X	General Practice Physician	ME0090686	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1881645802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VIVIANA PEREZ MD

Provider Business Mailing Address
First Line	:	4410 W 16TH AVE
Second Line	:	26
City	:	HIALEAH
State	:	FL
Zip	:	33012-7146
Country	:	US
Telephone Number	:	305-822-8883
Fax Number	:	305-825-8273

Provider Business Practice Location Address
First Line	:	4410 W 16TH AVE
Second Line	:	26
City	:	HIALEAH
State	:	FL
Zip	:	33012-7100
Country	:	US
Telephone Number	:	305-822-8883
Fax Number	:	305-825-8273

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	02/26/2008

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