Provider Demographics
NPI:1316187917
Name:KURY PEREZ, ELIZABETH MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIE
Last Name:KURY 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 1:4300 ALTON RD
Mailing Address - Street 2:2ND FLOOR ASCHER BLDG
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2948
Mailing Address - Country:US
Mailing Address - Phone:305-674-2841
Mailing Address - Fax:305-535-7919
Practice Address - Street 1:4304 ALTON RD.
Practice Address - Street 2:LOWENSTEIN BLDG
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2800
Practice Address - Country:US
Practice Address - Phone:305-674-2430
Practice Address - Fax:305-674-2413
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107783207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003219600Medicaid
FLME107783OtherMEDICAL LICENSE
FL003219600Medicaid