Provider Demographics
NPI:1588668347
Name:PERE, JAVIER FRANCISCO (MD)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:FRANCISCO
Last Name:PERE
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: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:513-981-5015
Mailing Address - Fax:
Practice Address - Street 1:770 W HIGH ST
Practice Address - Street 2:SUITE 240
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-3990
Practice Address - Country:US
Practice Address - Phone:419-996-2686
Practice Address - Fax:419-996-2687
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2014-12-18
Deactivation Date:2006-03-15
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
LA10683R174400000X
OH35.098697207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1990051Medicaid
OH0061404Medicaid
LA1990051Medicaid
OH0061404Medicaid