Provider Demographics
NPI:1881641199
Name:PEREZ, JORGE C (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:C
Last Name:PEREZ
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 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:305-667-1275
Practice Address - Street 1:3099 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4531
Practice Address - Country:US
Practice Address - Phone:305-644-3100
Practice Address - Fax:305-461-5911
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057463207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0057463OtherMEDICAL LICENSE
FLME0057463OtherMEDICAL LICENSE
FLBP1598133OtherDEA
FLE98498Medicare UPIN