Provider Demographics
NPI:1770652976
Name:PEREZ-GURRI, JOSE A (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:PEREZ-GURRI
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9955 N KENDALL DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1700
Mailing Address - Country:US
Mailing Address - Phone:305-596-2228
Mailing Address - Fax:305-596-2484
Practice Address - Street 1:9955 N KENDALL DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1700
Practice Address - Country:US
Practice Address - Phone:305-596-2228
Practice Address - Fax:305-596-2484
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0036429174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58983Medicare UPIN
FL79932Medicare ID - Type Unspecified