Perez, Gary Charles

Perez, Gary Charles is an individual health care provider with primary practice located at 550 Redstone Ave W Suite 370, Crestview FL 32536-6428. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Perez, Gary Charles can be contacted via phone (850) 682-2209.

Contact Information

Primary practice address
550 Redstone Ave W Suite 370 Crestview FL 32536-6428
Phone: (850) 682-2209
Fax: (850) 850-6822
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA 9103949 Florida

Profile Details

NPI number 1154512358
LBN Legal business name Perez, Gary Charles
Credentials PHYSICIAN ASSISTANT
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2007
Last updated Feb 9th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154512358 NPPES
Florida MEDICAID 002879600
Florida Other PA9103949
Florida MEDICAID 1467589010
Florida Other 592921954
Florida Other 1467589010

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