Individual provider Active NPI

Reynaldo J. Perez, M.D.

  • Psychiatry Physician
  • Saint Cloud, FL
National Provider Identifier
1306831110
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ACN1120 Issued in FL
Practice address
2013 Live Oak Blvd Ste B
Saint Cloud, FL 34771-8410
Phone
(407) 734-1273
NPI assigned
Sep 19, 2005
Last updated
Jan 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ACN1120 FL Primary

Addresses

Primary practice location

2013 Live Oak Blvd Ste B
Saint Cloud, FL 34771-8410

Mailing address

4944 Parkview Dr
Saint Cloud, FL 34771-7972
Phone (787) 466-8754

Other practice location 1

5425 S Semoran Blvd Ste 3
Orlando, FL 32822-1777
Phone (407) 734-1273

Other practice location 2

435 Ponce De Leon Ave
Hato Rey
Hato Rey, PR 00917-3428
Phone (787) 754-0909

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ACN1120FLMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1306831110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4944 PARKVIEW DR",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347717972",
            "telephone_number": "787-466-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 LIVE OAK BLVD STE B",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347718410",
            "telephone_number": "407-734-1273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5425 S Semoran Blvd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328221777",
            "country_code": "US",
            "telephone_number": "407-734-1273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "435 Ponce De Leon Ave",
            "address_2": "Hato Rey",
            "address_purpose": "LOCATION",
            "city": "Hato Rey",
            "state": "PR",
            "postal_code": "009173428",
            "country_code": "US",
            "telephone_number": "787-754-0909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "REYNALDO",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ACN1120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.