Provider Demographics
NPI:1588105076
Name:PEREZ, DORKIS
Entity type:Individual
Prefix:
First Name:DORKIS
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6652 FESTIVAL LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-3206
Mailing Address - Country:US
Mailing Address - Phone:407-591-2006
Mailing Address - Fax:
Practice Address - Street 1:1544 SEMINOLA BLVD
Practice Address - Street 2:116
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-3697
Practice Address - Country:US
Practice Address - Phone:786-261-5601
Practice Address - Fax:407-775-5039
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other