Provider Demographics
NPI:1750788220
Name:PEREZ, ALEXIS
Entity type:Individual
Prefix:MR
First Name:ALEXIS
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 W FLAGLER ST STE 124
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2096
Mailing Address - Country:US
Mailing Address - Phone:305-924-1471
Mailing Address - Fax:
Practice Address - Street 1:8300 W FLAGLER ST STE 124
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2096
Practice Address - Country:US
Practice Address - Phone:305-924-1471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service