Provider Demographics
NPI:1568466332
Name:PERE, ANA ISABEL (MD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:ISABEL
Last Name:PERE
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:PO BOX 636930
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:513-981-5123
Mailing Address - Fax:513-981-5015
Practice Address - Street 1:2745 FORT AMANDA RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-4805
Practice Address - Country:US
Practice Address - Phone:419-996-5700
Practice Address - Fax:419-996-5639
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10378R207Q00000X
OH35.098696207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1989223Medicaid
OH0061822Medicaid
OHH084400Medicare PIN
LAF87483Medicare UPIN