Healthcare Provider Details

I. General information

NPI: 1285509372
Provider Name (Legal Business Name): MISS YISEL CORBEA PEREZ SR.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 11/08/2025
Certification Date: 11/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6806 HEIDI RD
JACKSONVILLE FL
32277-2151
US

IV. Provider business mailing address

6806 HEIDI RD
JACKSONVILLE FL
32277-2151
US

V. Phone/Fax

Practice location:
  • Phone: 786-299-0045
  • Fax: 213-596-7118
Mailing address:
  • Phone: 786-299-0045
  • Fax: 213-596-7118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: