Provider Demographics
NPI:1932309754
Name:PERNAS, FRANCISCO G (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:G
Last Name:PERNAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15280 NW 79TH CT STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5873
Mailing Address - Country:US
Mailing Address - Phone:305-558-3724
Mailing Address - Fax:786-907-4485
Practice Address - Street 1:15955 SW 96TH ST
Practice Address - Street 2:# 303
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1271
Practice Address - Country:US
Practice Address - Phone:305-380-6773
Practice Address - Fax:786-533-1680
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10029084207Y00000X
FLME 108710207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1932309754Medicaid
FLGG708ZMedicare PIN