Provider Demographics
NPI:1366878365
Name:PEREZ, JOSEPH A (DC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:PEREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10304 NW 50TH CT
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-1738
Mailing Address - Country:US
Mailing Address - Phone:561-906-8666
Mailing Address - Fax:
Practice Address - Street 1:10304 NW 50TH CT
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-1738
Practice Address - Country:US
Practice Address - Phone:561-906-8666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10995111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor