Individual
DR. MODESTO PERALTA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
423 W FENWAY DR, HERNANDO, FL 34442-5144
(440) 567-0113
Mailing address
423 W FENWAY DR, HERNANDO, FL 34442-5144
(440) 567-0113
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
35.034631
OH
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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