Provider Demographics
NPI:1184890980
Name:PEREZ, BRANDON LUIS (MD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:LUIS
Last Name:PEREZ
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3600 PRYTANIA ST
Mailing Address - Street 2:STE 35
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3678
Mailing Address - Country:US
Mailing Address - Phone:504-897-8412
Mailing Address - Fax:504-249-5311
Practice Address - Street 1:1111 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 250 SOUTH
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3151
Practice Address - Country:US
Practice Address - Phone:504-349-6945
Practice Address - Fax:504-349-6949
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2019-06-14
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Provider Licenses
StateLicense IDTaxonomies
LA006322283207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1215791Medicaid