Individual
JORGE A PEREZ LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 N CLYDE MORRIS BLVD, SUITE 120, DAYTONA BEACH, FL 32114-2765
(386) 425-4641
(386) 947-4647
Mailing address
PO BOX 732901, DALLAS, TX 75373-2901
(386) 226-4590
(386) 226-3371
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME116773
FL
Other
Enumeration date
09/08/2009
Last updated
04/08/2016
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