Provider Demographics
NPI:1992235881
Name:PEREZ SOLIS, RENATO (MD)
Entity type:Individual
Prefix:
First Name:RENATO
Middle Name:
Last Name:PEREZ SOLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 GREENHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-4416
Mailing Address - Country:US
Mailing Address - Phone:585-953-1278
Mailing Address - Fax:
Practice Address - Street 1:6607 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3985
Practice Address - Country:US
Practice Address - Phone:813-499-1500
Practice Address - Fax:813-499-1499
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14184-I208D00000X
FLACN1158207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice