Provider Demographics
NPI:1114350444
Name:PEREZ, ADRIAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 N FLAGLER DR
Mailing Address - Street 2:STE 9800
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3423
Mailing Address - Country:US
Mailing Address - Phone:561-627-7776
Mailing Address - Fax:
Practice Address - Street 1:8200 BRYAN DAIRY RD
Practice Address - Street 2:STE 150
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1363
Practice Address - Country:US
Practice Address - Phone:727-565-0312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT28272225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist