Altagracia Josefina Perez, PA,SU, FOREIGN MD

Primary specialty

Pathology Specialist/TechnologistTaxonomy code 246Q00000X

License

SU41493 Issued in FL

Practice address

1115 SW 11TH Ave
Miami, FL 33129-1820

Phone

(305) 975-7541

Fax

(305) 225-8140

NPI assigned

Dec 28, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Altagracia Josefina Perez Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

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

{
    "created_epoch": "1356652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861738585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 557635",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332557635",
            "telephone_number": "305-975-7541",
            "fax_number": "305-225-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 SW 11TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331291820",
            "telephone_number": "305-975-7541",
            "fax_number": "305-225-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ALTAGRACIA",
        "middle_name": "JOSEFINA",
        "name_prefix": "Dr.",
        "credential": "PA,SU, FOREIGN MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Q00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology",
            "state": "NY",
            "license": "012984",
            "primary": false
        },
        {
            "code": "246Q00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology",
            "state": "FL",
            "license": "SU41493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FOREIGN M.D. & PATHOLOGIST (DOM. REP.)",
            "identifier": "M.D. 3907",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALTAGRACIA",
            "last_name": "PEREZ",
            "middle_name": "JOSEFINA",
            "prefix": "DR.",
            "credential": "FOREIGN PATHOLOGIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Alexis Perez, MSN, APRN, FNP-C
• Alexis Perez
• Alfred Perez, RPH
• Algenys Perez
• Alina Perez
• Amanda Perez, M.D.
• Amarilis Perez
• Ana Perez, MA
• Ana Perez
• Ana D Perez

• Pathology Specialist/Technologist in Miami, FL
• Providers in Miami, FL by specialty
• Pathology Specialist/Technologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.