MEDICARE: POMPILIO PEREZ 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	APRN11006644	FL

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	:	1558497909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	POMPILIO PEREZ ARNP

Provider Business Mailing Address
First Line	:	4850 SEASCAPE WAY APT 103
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-0624
Country	:	US
Telephone Number	:	786-543-2543
Fax Number	:	786-543-2543

Provider Business Practice Location Address
First Line	:	2104 MASSEY AVE
Second Line	:	BUILDING 2104
City	:	JACKSONVILLE
State	:	FL
Zip	:	32228
Country	:	US
Telephone Number	:	904-270-4303
Fax Number	:

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	11/21/2024

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