Provider Demographics
NPI:1326368515
Name:MEDICOS NASHVILLE FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:MEDICOS NASHVILLE FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LIMARIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA, CPC
Authorized Official - Phone:615-277-0760
Mailing Address - Street 1:4536 NOLENSVILLE PIKE STE F
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4786
Mailing Address - Country:US
Mailing Address - Phone:615-277-0760
Mailing Address - Fax:615-277-0765
Practice Address - Street 1:4536 NOLENSVILLE PIKE STE F
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4786
Practice Address - Country:US
Practice Address - Phone:615-277-0760
Practice Address - Fax:615-277-0765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1523614Medicaid
TN103G702220Medicare PIN