Provider Demographics
NPI:1588132559
Name:RENEE MARGARITA PEROCIER, M.D
Entity type:Organization
Organization Name:RENEE MARGARITA PEROCIER, M.D
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:PEROCIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-201-7041
Mailing Address - Street 1:4545 PLEASANT HILL RD STE 112
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3400
Mailing Address - Country:US
Mailing Address - Phone:407-201-7041
Mailing Address - Fax:407-201-8082
Practice Address - Street 1:4545 PLEASANT HILL RD #112
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3400
Practice Address - Country:US
Practice Address - Phone:407-201-7041
Practice Address - Fax:407-201-8082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-08
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104880400Medicaid