Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | ME0088669 | FL |
N | 2081P2900X | Pain Medicine | ME0088669 | FL |
NPI | 1083670160 |
---|---|
Provider Name | Roberto Perez-Millan |
First Address | Tampa, FL 33614-7166 |
Second Address | Tampa, FL 33614-7166 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 25/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1455194 | CIGNA (01) | FL |
16150 | BLUE CROSS (01) | FL |
2726645-00 | (05) | FL |
2874886 | UNITED (01) | FL |
7935347 | AETNA (01) | FL |
I29696 | (02) | FL |