Provider Demographics
NPI:1073627915
Name:PEREZ, LOURDES C (PT)
Entity Type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:C
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 SAN REMO AVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3043
Mailing Address - Country:US
Mailing Address - Phone:305-779-2427
Mailing Address - Fax:305-779-2437
Practice Address - Street 1:1500 SAN REMO AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3043
Practice Address - Country:US
Practice Address - Phone:305-779-2427
Practice Address - Fax:305-779-2437
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21967225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist