Individual
MARCO ANTONIO PERERA LLORENS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
5200 BAYVIEW DR, FORT LAUDERDALE, FL 33308-3436
(954) 907-7185
Mailing address
5200 BAYVIEW DR, FORT LAUDERDALE, FL 33308-3436
(954) 907-7185
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
24-138
FL
363A00000X
Physician Assistant
2999
PR
363AM0700X
Medical Physician Assistant
2999
PR
363AS0400X
Surgical Physician Assistant
2999
PR
Other
Enumeration date
02/12/2024
Last updated
02/02/2026
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