Provider Demographics
NPI:1780729137
Name:PEREZ, DIEGO FELIPE (NP)
Entity type:Individual
Prefix:
First Name:DIEGO
Middle Name:FELIPE
Last Name:PEREZ
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 MONROE ST.
Mailing Address - Street 2:BUILDING E #4
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560
Mailing Address - Country:US
Mailing Address - Phone:419-824-3433
Mailing Address - Fax:419-824-0216
Practice Address - Street 1:UNIVERSITY OF TOLEDO MEDICAL CENTER
Practice Address - Street 2:3000 ARLINGTON
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614
Practice Address - Country:US
Practice Address - Phone:419-383-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP05676363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner