Healthcare Provider Details

I. General information

NPI: 1528712718
Provider Name (Legal Business Name): ANABEL RODRIGUEZ PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2022
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 S HIGHWAY 29
CANTONMENT FL
32533-8699
US

IV. Provider business mailing address

2090 S HIGHWAY 29
CANTONMENT FL
32533-8699
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 866-389-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11017192
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: