Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 273256502 | FL |
NPI | 1174197966 |
---|---|
Provider Name | Tania E Perez |
First Address | Naples, FL 34116-5577 |
Second Address | Naples, FL 34116-5577 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2021 |
Last Update Date | 17/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
013900300 | (05) | FL |