Individual
DR. OMAR V PEREZ SOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2548 SIMPSON RD, KISSIMMEE, FL 34744
(407) 632-4201
(407) 632-4206
Mailing address
PO BOX 4189, DEERFIELD BEACH, FL 33442-4189
(954) 363-9582
(954) 363-9663
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
ACN800
FL
208D00000X
General Practice Physician
15643
PR
208D00000X
General Practice Physician
Primary
ACN800
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022909
PROVIDER NUMBER
PR
Enumeration date
07/25/2006
Last updated
02/22/2022
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