Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 30023354 | OH |
NPI | 1154623379 |
---|---|
Provider Name | Dr. Cecilia Perera |
First Address | Orlando, FL 32827-7403 |
Second Address | Orlando, FL 32827-7403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2010 |
Last Update Date | 20/04/2015 |