Provider Demographics
NPI:1598822181
Name:PEREZ VILA, JOSE A (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:PEREZ VILA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1435 W 49TH PL
Mailing Address - Street 2:SUITE 502
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3197
Mailing Address - Country:US
Mailing Address - Phone:305-823-8791
Mailing Address - Fax:305-444-4575
Practice Address - Street 1:1435 W 49TH PL
Practice Address - Street 2:SUITE 502
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3197
Practice Address - Country:US
Practice Address - Phone:305-823-8791
Practice Address - Fax:305-444-4575
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME62009207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370925600Medicaid
FL370925600Medicaid
F26200Medicare UPIN