Provider Demographics
NPI:1568677193
Name:PEREZ, OMNIA J (PA)
Entity Type:Individual
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First Name:OMNIA
Middle Name:J
Last Name:PEREZ
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1330 CORAL WAY
Mailing Address - Street 2:SUITE 403
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2929
Mailing Address - Country:US
Mailing Address - Phone:305-858-4598
Mailing Address - Fax:305-444-2782
Practice Address - Street 1:1330 CORAL WAY
Practice Address - Street 2:SUITE 403
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2929
Practice Address - Country:US
Practice Address - Phone:305-858-4598
Practice Address - Fax:305-444-2782
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
FLPA9100629363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant