Active NPI
Angel J Perez
- Optometrist
- Miami, FL
National Provider Identifier
1639330491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- D00002509
- Practice address
- 900 NW 17TH St
Miami, FL 33136-1119 - Phone
- (305) 326-6092
- Fax
- (305) 326-6374
- NPI assigned
- Jun 24, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | D00002509 | FL | Primary |
Addresses
Primary practice location
900 NW 17TH St
Miami, FL 33136-1119
Mailing address
900 NW 17TH St
Miami, FL 33136-1119
Phone (305) 326-6092
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 086127800 | Medicaid | FL | |
| 086624500 | Medicaid | FL |
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 |
|---|---|---|---|
| D00002509 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214265600000",
"number": "1639330491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 NW 17TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361119",
"telephone_number": "305-326-6092",
"fax_number": "305-326-6374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 NW 17TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361119",
"telephone_number": "305-326-6092",
"fax_number": "305-326-6374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "ANGEL",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-24",
"last_updated": "2008-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "D00002509",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "086127800",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "086624500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.