Provider Demographics
NPI:1245062272
Name:PEREZ VARGAS, GIOVANI (DC)
Entity type:Individual
Prefix:
First Name:GIOVANI
Middle Name:
Last Name:PEREZ VARGAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PINCON LN
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3807
Mailing Address - Country:US
Mailing Address - Phone:406-596-1679
Mailing Address - Fax:
Practice Address - Street 1:701 PINCON LN
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3807
Practice Address - Country:US
Practice Address - Phone:406-596-1679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15127111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor