Provider Demographics
NPI:1437577012
Name:PEREZ PASCUAL, HENDRY JULIAN (MD)
Entity Type:Individual
Prefix:
First Name:HENDRY
Middle Name:JULIAN
Last Name:PEREZ PASCUAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 JASMINE PARKE DR APT 1
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-3429
Mailing Address - Country:US
Mailing Address - Phone:424-272-1725
Mailing Address - Fax:844-895-3066
Practice Address - Street 1:5975 SUNSET DR STE 402
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5198
Practice Address - Country:US
Practice Address - Phone:305-669-2833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME143678207Q00000X
CAA144619207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA898036Medicaid