Provider Demographics
NPI:1417583444
Name:PEREZ RODRIGUEZ, LIZBETH LORENA (MD)
Entity Type:Individual
Prefix:MRS
First Name:LIZBETH
Middle Name:LORENA
Last Name:PEREZ RODRIGUEZ
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 1:1701 W CHARLESTON BLVD STE 290
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2302
Mailing Address - Country:US
Mailing Address - Phone:702-944-2805
Mailing Address - Fax:
Practice Address - Street 1:1701 W CHARLESTON BLVD STE 290
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2302
Practice Address - Country:US
Practice Address - Phone:407-970-4382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-21
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLL3456390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty