Healthcare Provider Details

I. General information

NPI: 1033074331
Provider Name (Legal Business Name): RIDER PEREZ SANCHEZ APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9125 SW 87TH AVE
MIAMI FL
33176-2302
US

IV. Provider business mailing address

9125 SW 87TH AVE
MIAMI FL
33176-2302
US

V. Phone/Fax

Practice location:
  • Phone: 305-602-9667
  • Fax: 305-396-5961
Mailing address:
  • Phone: 305-602-9667
  • Fax: 305-396-5961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPR11044112
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: