Provider Demographics
NPI:1770314312
Name:PEREZ RAMIREZ, ADRIAN CARLOS
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:CARLOS
Last Name:PEREZ RAMIREZ
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 1:11351 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33325-2903
Mailing Address - Country:US
Mailing Address - Phone:212-305-6100
Mailing Address - Fax:
Practice Address - Street 1:11351 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33325-2903
Practice Address - Country:US
Practice Address - Phone:305-699-2064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program