Healthcare Provider Details

I. General information

NPI: 1366360653
Provider Name (Legal Business Name): SPECTRUM MEDICAL PARTNERS FLORIDA MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 TECHNOLOGY PARK
LAKE MARY FL
32746-7107
US

IV. Provider business mailing address

23730 TERRELL LN
LAND O LAKES FL
34639-5313
US

V. Phone/Fax

Practice location:
  • Phone: 407-647-2346
  • Fax:
Mailing address:
  • Phone: 240-838-9620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. MIRIAN BEVERLY PEREZ
Title or Position: SOCIAL WORKER
Credential: MSW
Phone: 240-838-9620