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Contact Information

MARIO M PERDOMO SANTA CRUZ, RNFA
4300 BUXTON DR
LOUISVILLE, KY40218-2304
 Phone: 786-675-1616
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Registered Nurse First Assistant

163WR0006X
 

Surgical Assistant

246ZC0007X
Indicates primary specialty

NPI Profile & details for MARIO M PERDOMO SANTA CRUZ · (Male)

NPI # 1427776095
Status Active
Credentials RNFA
Entity Individual
Enumeration date 08/18/2022
Last updated 08/18/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • KY License # 1174207
  • KY License # 22-492
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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