Provider Demographics
NPI:1497164024
Name:PEREZ BARROSO, AHMED (C-SA)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:PEREZ BARROSO
Suffix:
Gender:M
Credentials:C-SA
Other - Prefix:
Other - First Name:AHMED
Other - Middle Name:
Other - Last Name:PEREZ BARROSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SURGICAL ASSISTANT
Mailing Address - Street 1:8260 SW 27 TR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155
Mailing Address - Country:US
Mailing Address - Phone:305-823-5000
Mailing Address - Fax:
Practice Address - Street 1:8260 SW 27 TR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155
Practice Address - Country:US
Practice Address - Phone:305-823-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11-247246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist