Doctor Name: | ALFONSO PEREZ |
NPI Number: | 1053777698 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PTA |
License Number: | PTA 26376 |
Business Practice Address: | 1310 37th St Vero Beach, FL - 329604860 |
Business Phone Number: | 8303252952 |
Business Fax Number: | |
Mailing Address: | 1604 Camarinos Dr, EAGLE PASS |
State: | TX |
Postal Code: | 788525562 |
Phone Number: | 8303252952 |
Fax Number: | |
NPI Enumeration Date: | 01/12/2016 |
NPI Last Update Date: | 01/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | PTA 26376 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |