Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | ME0044991 | FL |
NPI | 1003897638 |
---|---|
Provider Name | Don J Perez |
First Address | Tampa, FL 33603-2724 |
Second Address | Tampa, FL 33603-2724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D54118 | (02) | FL |