Provider Demographics
NPI:1922761246
Name:PEREZ PEREZ, WARREN PATRICK
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:PATRICK
Last Name:PEREZ PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 COOL MEADOW WAY
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN INN
Mailing Address - State:SC
Mailing Address - Zip Code:29644-9259
Mailing Address - Country:US
Mailing Address - Phone:347-886-6339
Mailing Address - Fax:
Practice Address - Street 1:6 COOL MEADOW WAY
Practice Address - Street 2:
Practice Address - City:FOUNTAIN INN
Practice Address - State:SC
Practice Address - Zip Code:29644-9259
Practice Address - Country:US
Practice Address - Phone:347-886-6339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)