Provider Demographics
NPI:1942335443
Name:PEREZ, MILADYS SARAY (MILADYS PEREZ)
Entity Type:Individual
Prefix:MRS
First Name:MILADYS
Middle Name:SARAY
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MILADYS PEREZ
Other - Prefix:MRS
Other - First Name:MILADYS
Other - Middle Name:SARAY
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MILADYS PEREZ
Mailing Address - Street 1:18600 NW 47TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-2509
Mailing Address - Country:US
Mailing Address - Phone:305-474-9700
Mailing Address - Fax:
Practice Address - Street 1:7000 W 12TH AVE STE 4
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5154
Practice Address - Country:US
Practice Address - Phone:305-822-0678
Practice Address - Fax:305-822-0698
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9103604363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant