Provider Demographics
NPI:1740547371
Name:PEREZ, ADRIAN MARCEL (MD)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:MARCEL
Last Name:PEREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ADRIAN
Other - Middle Name:MARCEL
Other - Last Name:PEREZ CAMACHO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3160 W 76TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-3886
Mailing Address - Country:US
Mailing Address - Phone:305-539-9767
Mailing Address - Fax:305-539-9309
Practice Address - Street 1:13903 NW 67TH AVE
Practice Address - Street 2:SUITE 440
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2900
Practice Address - Country:US
Practice Address - Phone:305-882-7747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME125032207Q00000X, 207Q00000X
NY281463207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine