Healthcare Provider Details

I. General information

NPI: 1427765544
Provider Name (Legal Business Name): RENE PEREZ GARCIA APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2022
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1154 LEE BLVD STE 4
LEHIGH ACRES FL
33936-4852
US

IV. Provider business mailing address

4325 6TH ST W
LEHIGH ACRES FL
33971-1219
US

V. Phone/Fax

Practice location:
  • Phone: 239-688-0033
  • Fax: 239-688-0024
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11022592
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: