Provider Demographics
NPI:1821190554
Name:PEREZ, DENIS A (MD)
Entity Type:Individual
Prefix:DR
First Name:DENIS
Middle Name:A
Last Name:PEREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DENIS
Other - Middle Name:ALBERTO
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8043 SPYGLASS HILL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8563
Mailing Address - Country:US
Mailing Address - Phone:321-265-5116
Mailing Address - Fax:321-241-6520
Practice Address - Street 1:8043 SPYGLASS HILL RD STE 101
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8563
Practice Address - Country:US
Practice Address - Phone:321-265-5116
Practice Address - Fax:321-241-6520
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66884207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26195OtherFLORIDA BCBS
FL376625000Medicaid
FL376625000Medicaid
FL7737065OtherAETNA
FL376625000Medicaid
FLE86960Medicare UPIN
FL160033921OtherRAILROAD MEDICARE