Provider Demographics
NPI:1245296631
Name:PEREZ MORALES, JUAN C (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:C
Last Name:PEREZ MORALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7765 SW 87TH AVE STE 110A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2535
Mailing Address - Country:US
Mailing Address - Phone:305-395-1441
Mailing Address - Fax:888-975-1250
Practice Address - Street 1:7765 SW 87TH AVE STE 110A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2535
Practice Address - Country:US
Practice Address - Phone:305-395-1441
Practice Address - Fax:888-975-1250
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0059704207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053493500Medicaid
FL34390OtherBCBS
FLK2459Medicare ID - Type UnspecifiedGROUP
FL053493500Medicaid
FL12346YMedicare ID - Type Unspecified