Individual provider Active NPI

Fernando Javier Perez, MD

  • Pediatric Critical Care Medicine Physician
  • Miami, FL
National Provider Identifier
1063672061
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
ME114498 Issued in FL
Practice address
11760 SW 40TH St Ste 722
Miami, FL 33175
Phone
(305) 559-1334
NPI assigned
Jun 12, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME114498 FL
Pediatric Critical Care Medicine Physician 2080P0203X ME114498 FL Primary

Addresses

Primary practice location

11760 SW 40TH St Ste 722
Miami, FL 33175

Mailing address

11760 SW 40TH St Ste 722
Miami, FL 33175-8101
Phone (300) 559-1334

Other practice location 1

8580 SW 113th Ter
Miami, FL 33156-4332
Phone (786) 269-8527

Other identifiers 1

IdentifierTypeStateIssuer
016959100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190408001641 FL Practitioner - Pediatric Medicine 6103167853

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: fernando.perez@hca4.eclinicaldirectplus.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1063672061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11760 SW 40TH ST STE 722",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331758101",
            "telephone_number": "300-559-1334",
            "fax_number": "305-559-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11760 SW 40TH ST STE 722",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33175",
            "telephone_number": "305-559-1334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8580 SW 113th Ter",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331564332",
            "country_code": "US",
            "telephone_number": "786-269-8527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "FERNANDO",
        "middle_name": "JAVIER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME114498",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME114498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016959100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.