Provider Demographics
NPI:1659948685
Name:PEREZ COLOME, ERNESTO AMERICO (MD)
Entity Type:Individual
Prefix:
First Name:ERNESTO
Middle Name:AMERICO
Last Name:PEREZ COLOME
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 1:11750 BIRD ROAD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175
Mailing Address - Country:US
Mailing Address - Phone:305-223-3000
Mailing Address - Fax:305-227-5556
Practice Address - Street 1:11750 BIRD ROAD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175
Practice Address - Country:US
Practice Address - Phone:305-223-3000
Practice Address - Fax:305-227-5556
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2023-08-28
Deactivation Date:2023-04-05
Deactivation Code:
Reactivation Date:2023-08-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program