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Individual
RUBEN JESUS PERDOMO
Active
Individual
RUBEN JESUS PERDOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2896962
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
592-10270
BLUE CROSS BLUE SHIELD
AL
01
—
ARNP2896962
FL LICENSE
FL
01
—
G3834
FL BCBS
FL
01
—
P00242573
MEDICARE RAILROAD
FL
01
—
P00957902
MEDICARE RAILROAD
—
Enumeration date
01/25/2007
Last updated
12/14/2011
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