Provider Demographics
NPI:1396731964
Name:PEREZ, ALEJANDRA (MD)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALEJANDRA
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 862233
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-2233
Mailing Address - Country:US
Mailing Address - Phone:954-265-6990
Mailing Address - Fax:954-965-6388
Practice Address - Street 1:3700 JOHNSON STREET
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021
Practice Address - Country:US
Practice Address - Phone:954-265-6990
Practice Address - Fax:954-965-6388
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL80220207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265115700Medicaid
FLE4415ZMedicare ID - Type Unspecified
FL265115700Medicaid