Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN16203 | FL |
NPI | 1114138617 |
---|---|
Provider Name | Ramon A Perez |
First Address | Plantation, FL 33322-7617 |
Second Address | Plantation, FL 33322-7617 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 25/01/2008 |