Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 29955 | NE |
Y | 208000000X | Pediatrician | ME140301 | FL |
N | 2080P0204X | Pediatric Emergency Doctor | Q3765 | TX |
NPI | 1225399116 |
---|---|
Provider Name | Dr. Mathew Peralta |
First Address | Orlando, FL 32837-7669 |
Second Address | Orlando, FL 32837-7669 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2012 |
Last Update Date | 09/08/2019 |