Provider Demographics
NPI:1427765544
Name:PEREZ GARCIA, RENE
Entity type:Individual
Prefix:DR
First Name:RENE
Middle Name:
Last Name:PEREZ GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9751 SW 152ND ST APT 604
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1792
Mailing Address - Country:US
Mailing Address - Phone:786-350-6884
Mailing Address - Fax:
Practice Address - Street 1:9751 SW 152ND ST APT 604
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1792
Practice Address - Country:US
Practice Address - Phone:786-350-6884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-28
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022592363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFNPOther11022592