Individual
DR. LUIS L. PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1250 W NATIONAL RD STE 400, ENGLEWOOD, OH 45315-9506
(937) 836-6000
(937) 832-4805
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8068
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34.009754
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01050656
GROUP MEDICAID
OH
01
—
1184652539
GROUP NPI
OH
05
—
3141817
—
OH
01
—
34-1689161
GROUP TAX ID
OH
01
—
9934723
GROUP MEDICARE PTAN
OH
01
—
H319241
MEDICARE PTAN
OH
Enumeration date
08/15/2008
Last updated
04/21/2023
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