Provider Demographics
NPI:1497510275
Name:PEREZ & PEREZ MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:PEREZ & PEREZ MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:786-232-5294
Mailing Address - Street 1:1321 SW 107TH AVE STE 211A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2522
Mailing Address - Country:US
Mailing Address - Phone:786-238-7439
Mailing Address - Fax:786-814-5703
Practice Address - Street 1:1321 SW 107TH AVE STE 211A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2522
Practice Address - Country:US
Practice Address - Phone:786-238-7439
Practice Address - Fax:786-814-5703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty