Provider Demographics
NPI:1720470321
Name:PERERA FLORES, GILBERTO (CSA)
Entity Type:Individual
Prefix:
First Name:GILBERTO
Middle Name:
Last Name:PERERA FLORES
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 CENTERVIEW DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5274
Mailing Address - Country:US
Mailing Address - Phone:888-348-4565
Mailing Address - Fax:888-468-6511
Practice Address - Street 1:1600 SARNO RD
Practice Address - Street 2:SUITE 15
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-4938
Practice Address - Country:US
Practice Address - Phone:888-348-4565
Practice Address - Fax:888-468-6511
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant