MEDICARE: CARLOS MANUEL PEREZ HERNANDEZ ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F04210204	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11015094	FL
3	247200000X	Other Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356864300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS MANUEL PEREZ HERNANDEZ ARNP

Provider Business Mailing Address
First Line	:	4932 SW 142ND PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-5024
Country	:	US
Telephone Number	:	786-234-3049
Fax Number	:

Provider Business Practice Location Address
First Line	:	4932 SW 142ND PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-5024
Country	:	US
Telephone Number	:	786-234-3049
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2017
Last Update Date	:	02/11/2026

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