Provider Demographics
NPI:1881412690
Name:PEREZ GONZALEZ, ALEJANDRO
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:PEREZ GONZALEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2898 RIVERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-6591
Mailing Address - Country:US
Mailing Address - Phone:941-267-5786
Mailing Address - Fax:
Practice Address - Street 1:2898 RIVERFIELD RD
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-6591
Practice Address - Country:US
Practice Address - Phone:941-267-5786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program