Provider Demographics
NPI:1407930589
Name:VERDEJA PEREZ, ANA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:M
Last Name:VERDEJA PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1601 W TIMBERLANE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33566-0957
Mailing Address - Country:US
Mailing Address - Phone:813-321-6677
Mailing Address - Fax:
Practice Address - Street 1:1601 W TIMBERLANE DR STE 400
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33566
Practice Address - Country:US
Practice Address - Phone:813-321-6677
Practice Address - Fax:813-443-8153
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78928207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257571000Medicaid
FLG31143Medicare UPIN
FL257571000Medicaid