Provider Demographics
NPI:1578982179
Name:PEREZ MIRANDA, LENIER (MD)
Entity Type:Individual
Prefix:
First Name:LENIER
Middle Name:
Last Name:PEREZ MIRANDA
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 1:12320 QUAIL ROOST DRIVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177
Mailing Address - Country:US
Mailing Address - Phone:786-237-3070
Mailing Address - Fax:786-430-8198
Practice Address - Street 1:12320 QUAIL ROOST DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-4930
Practice Address - Country:US
Practice Address - Phone:786-237-3070
Practice Address - Fax:786-430-8198
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME130889207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine