Provider Demographics
NPI:1326089244
Name:BELONGIE, IRIANA PEREZ (MD)
Entity Type:Individual
Prefix:DR
First Name:IRIANA
Middle Name:PEREZ
Last Name:BELONGIE
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 1:504 SHORE DR W
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3420
Mailing Address - Country:US
Mailing Address - Phone:727-710-3517
Mailing Address - Fax:
Practice Address - Street 1:3165 N MCMULLEN BOOTH RD BLDG B
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2020
Practice Address - Country:US
Practice Address - Phone:727-258-9143
Practice Address - Fax:727-823-7043
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94154207ND0900X, 207NP0225X, 207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008260000Medicaid