Bolivar Alberto Perez-Diaz, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME111897 Issued in FL

Practice address

10060 NW 7TH St
Pembroke Pines, FL 33024-6158

Phone

(954) 606-0110

Fax

(954) 495-4162

NPI assigned

Jan 2, 2008

Last updated

Jan 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Miami Beach Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Miami Beach, FL
  • NPI 1063411874
  Medicare reassignment NPD
• Access Medical Group of Margate, LLC

  dba Community Medical Group

  • Family Medicine Physician
  • Margate, FL
  • NPI 1295472066
  Medicare reassignment
• Access Medical Group of Pembroke Pines, LLC

  dba Community Medical Group

  • Family Medicine Physician
  • Pembroke Pines, FL
  • NPI 1235876004
  Medicare reassignment
• Miami Beach Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Miami, FL
  • NPI 1053780734
  NPD
• Miami Beach Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Miami, FL
  • NPI 1891116497
  NPD

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1649455254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 BLUE LAGOON DR STE 365",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331267010",
            "telephone_number": "786-322-7333",
            "fax_number": "786-347-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10060 NW 7TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246158",
            "telephone_number": "954-606-0110",
            "fax_number": "954-495-4162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4337 N State Road 7",
            "address_purpose": "LOCATION",
            "city": "Lauderdale Lakes",
            "state": "FL",
            "postal_code": "333194856",
            "country_code": "US",
            "telephone_number": "954-676-8873",
            "fax_number": "954-282-8005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2416 N State Road 7",
            "address_purpose": "LOCATION",
            "city": "Margate",
            "state": "FL",
            "postal_code": "330635720",
            "country_code": "US",
            "telephone_number": "954-779-5610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ-DIAZ",
        "first_name": "BOLIVAR",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-02",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "002995",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME111897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014027400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arelys Perez Rosete
• Sisley Perez Santana
• Alfredo Perez Tagle Tejeda, MD
• Lianet Beatriz Perez Veitia
• Jessenia Perez-Carrion, PSY.D.
• Adriana Maria Perez, L.AC.
• Alejandra E Perez
• Alessandra Valentina Perez
• Alyssa Nicole Perez
• Ana Maria Perez, BCABA

• Internal Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.