Provider Demographics
NPI:1417081191
Name:LAURENTIN PEREZ, LUIS ALFREDO (MD PHD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ALFREDO
Last Name:LAURENTIN PEREZ
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27348 CASHFORD CIR STE 102
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-8198
Mailing Address - Country:US
Mailing Address - Phone:813-895-5581
Mailing Address - Fax:888-369-3691
Practice Address - Street 1:27348 CASHFORD CIR STE 102
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-8198
Practice Address - Country:US
Practice Address - Phone:813-895-5581
Practice Address - Fax:888-369-3691
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98258207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery