Provider Demographics
NPI:1760865182
Name:PEREZ PELIPICHE, YAMILE
Entity Type:Individual
Prefix:
First Name:YAMILE
Middle Name:
Last Name:PEREZ PELIPICHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 W 68TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1802
Mailing Address - Country:US
Mailing Address - Phone:305-827-2977
Mailing Address - Fax:305-820-6373
Practice Address - Street 1:2150 W 68TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:305-827-2977
Practice Address - Fax:305-820-6373
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME137123207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine