Provider Demographics
NPI:1215283908
Name:PEREZ GONZALEZ, RAFAEL (MD)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:
Last Name:PEREZ GONZALEZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10821 NW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33167-3407
Mailing Address - Country:US
Mailing Address - Phone:305-381-0193
Mailing Address - Fax:305-437-7625
Practice Address - Street 1:10821 NW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33167-3407
Practice Address - Country:US
Practice Address - Phone:305-381-0193
Practice Address - Fax:305-437-7625
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME159219208D00000X
FLACN848208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice