Active NPI
Elaine Perez Gutierrez
- General Practice Dentistry
- Aventura, FL
National Provider Identifier
1255901047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 26135
- Practice address
- 2627 NE 203Rd St Ste 112
Aventura, FL 33180-1945 - Phone
- (305) 339-5701
- Fax
- (305) 394-6106
- NPI assigned
- Jun 25, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 26135 | FL | Primary |
Addresses
Primary practice location
2627 NE 203Rd St Ste 112
Aventura, FL 33180-1945
Mailing address
18895 NW 77TH CT
Hialeah, FL 33015-5281
Phone (941) 320-1892
Other practice location 1
18895 NW 77th Ct
Hialeah, FL 33015-5281
Phone (941) 320-1892
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 |
|---|---|---|---|
| 26135 | FL | MD | Student in an Organized Health Care Education/Training Program |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718755200000",
"number": "1255901047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18895 NW 77TH CT",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330155281",
"telephone_number": "941-320-1892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2627 NE 203RD ST STE 112",
"city": "AVENTURA",
"state": "FL",
"postal_code": "331801945",
"telephone_number": "305-339-5701",
"fax_number": "305-394-6106"
}
],
"practiceLocations": [
{
"address_1": "18895 NW 77th Ct",
"address_purpose": "LOCATION",
"city": "Hialeah",
"state": "FL",
"postal_code": "330155281",
"country_code": "US",
"telephone_number": "941-320-1892",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEREZ GUTIERREZ",
"first_name": "ELAINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-25",
"last_updated": "2024-06-19",
"certification_date": "2024-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "26135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aventura, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.