Perez, Mark David
Perez, Mark David is an sole proprietor health care provider with primary practice located at 3601 W Commercial Blvd Ste 20 , Fort Lauderdale FL 33309-3334. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Perez, Mark David can be contacted via phone (954) 368-4560.Contact Information
Primary practice address
3601 W Commercial Blvd Ste 20
Fort Lauderdale FL 33309-3334
Phone: (954) 368-4560
Fax: (954) 530-6418
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME130601 | Florida |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 9700706 | North Carolina |
Profile Details
| NPI number | 1396740783 |
|---|---|
| LBN Legal business name | Perez, Mark David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 14th, 2005 |
| Last updated | May 26th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396740783 | NPPES |
| North Carolina | MEDICAID | 891306J | |
| North Carolina | Other | C3864 | |
| North Carolina | Other | 1306J | |
| North Carolina | Other | 080192422 | |
| North Carolina | Other | 39-01069 | |
| North Carolina | Other | 080185873 |
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