Individual provider Active NPI

Pedro D Carrazana Perez, M.D.

  • Internal Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1558367243
Registry record updated Nov 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ACN450 Issued in FL
Practice address
907 N Central Ave Ste a
Kissimmee, FL 34741-5002
Phone
(407) 846-2050
Fax
(407) 846-0338
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 15309 PR
Internal Medicine Physician 207R00000X ACN450 FL Primary
Family Medicine Physician 207Q00000X ACN450 FL

Addresses

Primary practice location

907 N Central Ave Ste a
Kissimmee, FL 34741-5002

Mailing address

907 N Central Ave Ste a
Kissimmee, FL 34741-5002
Phone (407) 846-2050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20050126000620 PR Practitioner - Internal Medicine 9234189390 Practice locations: Toa Bja, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15309PRMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384387200000",
    "number": "1558367243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 N CENTRAL AVE STE A",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415002",
            "telephone_number": "407-846-2050",
            "fax_number": "407-846-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 N CENTRAL AVE STE A",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415002",
            "telephone_number": "407-846-2050",
            "fax_number": "407-846-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRAZANA PEREZ",
        "first_name": "PEDRO",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2013-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "15309",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ACN450",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ACN450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.