Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | ME103841 | FL |
N | 2080P0201X | Pediatric Allergist | ME103841 | FL |
NPI | 1700805694 |
---|---|
Provider Name | Elena E Perez |
First Address | North Palm Beach, FL 33408-3830 |
Second Address | North Palm Beach, FL 33408-3830 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 17/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000700200 | (05) | FL |
29887 | BLUE CROSS BLUE SHIELD (01) | FL |
H58201 | (02) |