Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME113431 | FL |
N | 207ND0101X | MOHS-Micrographic Surgeon | ME113431 | FL |
N | 207NS0135X | Procedural Dermatology | ME113431 | FL |
NPI | 1245432970 |
---|---|
Provider Name | Dr. Oliver Angel Perez |
First Address | Jacksonville, FL 32217-2358 |
Second Address | Jacksonville, FL 32207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 10/10/2018 |