Provider Demographics
NPI:1437145661
Name:PEREZ, LIGIA (MD)
Entity Type:Individual
Prefix:
First Name:LIGIA
Middle Name:
Last Name:PEREZ
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 1:470 2ND ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4330
Mailing Address - Country:US
Mailing Address - Phone:727-893-6060
Mailing Address - Fax:727-893-6061
Practice Address - Street 1:470 2ND ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4330
Practice Address - Country:US
Practice Address - Phone:727-893-6060
Practice Address - Fax:727-893-6061
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116822300Medicaid
FL35275XMedicare PIN
FL258886200Medicaid