Provider Demographics
NPI:1659367696
Name:PEREZ-FERNANDEZ, JAVIER
Entity Type:Individual
Prefix:MR
First Name:JAVIER
Middle Name:
Last Name:PEREZ-FERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 SW 92ND ST STE 204B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7377
Mailing Address - Country:US
Mailing Address - Phone:305-661-9404
Mailing Address - Fax:305-275-8687
Practice Address - Street 1:8600 SW 92ND ST STE 204B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7377
Practice Address - Country:US
Practice Address - Phone:305-661-9404
Practice Address - Fax:305-275-8687
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84210207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261877000Medicaid
FLH50645Medicare UPIN
FLE6420YMedicare PIN