Provider Demographics
NPI:1366447625
Name:PEREZ-CLAVIJO, FRANCISCO MANUEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:MANUEL
Last Name:PEREZ-CLAVIJO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8339 NW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1841
Mailing Address - Country:US
Mailing Address - Phone:305-592-2996
Mailing Address - Fax:
Practice Address - Street 1:8339 NW 12TH ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1841
Practice Address - Country:US
Practice Address - Phone:305-592-2926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2909213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340174000Medicaid
FLU85145Medicare UPIN
FLE5561Medicare PIN