Provider Demographics
NPI:1104645647
Name:PEREZ PEREZ, FLAVIA C
Entity type:Individual
Prefix:
First Name:FLAVIA
Middle Name:C
Last Name:PEREZ PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 NORMANDY DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-4458
Mailing Address - Country:US
Mailing Address - Phone:305-503-1003
Mailing Address - Fax:
Practice Address - Street 1:2000 NORMANDY DR
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-4458
Practice Address - Country:US
Practice Address - Phone:305-503-1003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-09
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy