Provider Demographics
NPI:1952538142
Name:PEREZ, MONICA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13442 CANOPY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-5916
Mailing Address - Country:US
Mailing Address - Phone:305-219-8991
Mailing Address - Fax:
Practice Address - Street 1:15711 MAPLEDALE DR STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-3112
Practice Address - Country:US
Practice Address - Phone:813-624-1600
Practice Address - Fax:813-264-1660
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN186551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice