Provider Demographics
NPI:1891193231
Name:PEREZ, MARGARET (RPT20088)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:RPT20088
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5994 SW 18TH ST STE D7
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-7102
Mailing Address - Country:US
Mailing Address - Phone:561-417-3866
Mailing Address - Fax:561-417-3854
Practice Address - Street 1:5994 SW 18TH ST STE D7
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-7102
Practice Address - Country:US
Practice Address - Phone:561-417-3866
Practice Address - Fax:561-417-3854
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20088225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38108OtherFLORIDA BLUE