Provider Demographics
NPI:1194342626
Name:PEREZ, RACHEL (DMD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7483 SW 109TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2741
Mailing Address - Country:US
Mailing Address - Phone:786-547-5337
Mailing Address - Fax:
Practice Address - Street 1:4011 W FLAGLER ST STE 506
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1643
Practice Address - Country:US
Practice Address - Phone:305-643-1444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN25053122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist