Healthcare Provider Details

I. General information

NPI: 1548934052
Provider Name (Legal Business Name): MADYS PEREZ TORRES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2021
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11501 SW 40TH ST
MIAMI FL
33165-3313
US

IV. Provider business mailing address

13412 SW 43RD LN
MIAMI FL
33175-3860
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-5366
  • Fax: 305-644-6407
Mailing address:
  • Phone: 786-599-4382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11014749
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: