NPIMap

Organization Active NPI

Ernesto J Perez MD LLC

  • Legal Medicine
  • Winter Haven, FL
National Provider Identifier
1679679872
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
ME0055358 Issued in FL
Legal business name
ERNESTO J PEREZ MD LLC
Practice address
1450 6TH Street SE
Winter Haven, FL 33880-4505
Phone
(863) 299-1485
Fax
(863) 291-3572
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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

Authorized official

Name
Ernesto J Perez, MDNPI 1275556268
Title
Owner
Phone
(863) 299-1485

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193200000X MULTI-SPECIALTY GROUP 173000000X ME0055358 FL Primary

Addresses

Primary practice location

1450 6TH Street SE
Winter Haven, FL 33880-4505

Mailing address

1450 6TH Street SE
Winter Haven, FL 33880-4505
Phone (863) 299-1485

National Provider Directory

National Provider Directory

Locations

564 Avenue K SE
Winter Haven, FL 33880
Phone (863) 968-9662

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1679679872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 6TH STREET SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804505",
            "telephone_number": "863-299-1485",
            "fax_number": "863-291-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 6TH STREET SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804505",
            "telephone_number": "863-299-1485",
            "fax_number": "863-291-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERNESTO J PEREZ MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ERNESTO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-299-1485",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "FL",
            "license": "ME0055358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.