Active NPI
George Pino Perez Sr.
- Medical Physician Assistant
- Doral, FL
National Provider Identifier
1225543762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 000882-P.A.
- Practice address
- 2555 NW 102ND Ave Ste 110
Doral, FL 33172-1301 - Phone
- (305) 597-8707
- NPI assigned
- Dec 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Medical Physician Assistant | 363AM0700X | 000882-P.A. | PR | Primary |
Addresses
Primary practice location
2555 NW 102ND Ave Ste 110
Doral, FL 33172-1301
Mailing address
4400 NW 79TH Ave Apt 114
Doral, FL 33166-6303
Phone (786) 624-1454
Other practice location 1
8247 NW 36th St
Doral, FL 33166-6613
Phone (786) 585-6614
Other practice location 2
1665 W 68th St Ste 201
Hialeah, FL 33014-4400
Phone (786) 773-3393
Other practice location 3
4400 NW 79th Ave Apt 114
Doral, FL 33166-6303
Phone (786) 624-1454
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000882-P.A. | PR | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726617600000",
"number": "1225543762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 NW 79TH AVE APT 114",
"city": "DORAL",
"state": "FL",
"postal_code": "331666303",
"telephone_number": "786-624-1454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2555 NW 102ND AVE STE 110",
"city": "DORAL",
"state": "FL",
"postal_code": "331721301",
"telephone_number": "305-597-8707"
}
],
"practiceLocations": [
{
"address_1": "8247 NW 36th St",
"address_purpose": "LOCATION",
"city": "Doral",
"state": "FL",
"postal_code": "331666613",
"country_code": "US",
"telephone_number": "786-585-6614",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1665 W 68th St Ste 201",
"address_purpose": "LOCATION",
"city": "Hialeah",
"state": "FL",
"postal_code": "330144400",
"country_code": "US",
"telephone_number": "786-773-3393",
"fax_number": "786-773-3394",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4400 NW 79th Ave Apt 114",
"address_purpose": "LOCATION",
"city": "Doral",
"state": "FL",
"postal_code": "331666303",
"country_code": "US",
"telephone_number": "786-624-1454",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PINO PEREZ",
"first_name": "GEORGE",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-12-06",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PR",
"license": "000882-P.A.",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Doral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.