Provider Demographics
NPI:1700805694
Name:PEREZ, ELENA E (MD)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:E
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 US HIGHWAY 1
Mailing Address - Street 2:SUITE 235
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3830
Mailing Address - Country:US
Mailing Address - Phone:561-626-2006
Mailing Address - Fax:561-626-8622
Practice Address - Street 1:840 US HIGHWAY 1
Practice Address - Street 2:SUITE 235
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3830
Practice Address - Country:US
Practice Address - Phone:561-626-2006
Practice Address - Fax:561-626-8622
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1038412080P0201X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL29887OtherBLUE CROSS BLUE SHIELD
FL000700200Medicaid
FL29887OtherBLUE CROSS BLUE SHIELD
FL000700200Medicaid