Provider Demographics
NPI:1215224043
Name:PEREZ, MARIBELIS (MD)
Entity Type:Individual
Prefix:
First Name:MARIBELIS
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14027 5TH ST
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33525-4302
Mailing Address - Country:US
Mailing Address - Phone:352-518-2000
Mailing Address - Fax:
Practice Address - Street 1:14027 5TH ST
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525-4302
Practice Address - Country:US
Practice Address - Phone:813-782-6064
Practice Address - Fax:813-782-0984
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME112229208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics