Healthcare Provider Details

I. General information

NPI: 1265837348
Provider Name (Legal Business Name): ARIEL J PEREZ ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2014
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5378 W 16TH AVE
HIALEAH FL
33012
US

IV. Provider business mailing address

5378 W 16TH AVE
HIALEAH FL
33012-2165
US

V. Phone/Fax

Practice location:
  • Phone: 305-820-4101
  • Fax: 305-821-5698
Mailing address:
  • Phone: 305-820-4101
  • Fax: 305-821-5698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9292464
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: