Individual
MYRIAM C PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16 ST JOHNS MEDICAL PARK DR, ST AUGUSTINE, FL 32086-5299
(904) 794-5411
(904) 794-4224
Mailing address
16 ST JOHNS MEDICAL PARK DR, ST AUGUSTINE, FL 32086-5299
(904) 794-5411
(904) 794-4224
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
ME27768
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
059094100
—
FL
01
—
78499
BLUE CROSS/SHIELD
—
Enumeration date
07/10/2006
Last updated
01/08/2010
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