Healthcare Provider Details

I. General information

NPI: 1639634652
Provider Name (Legal Business Name): BARBARA PEREZ-GASPAR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2019
Last Update Date: 02/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 NW 25TH CT
MIAMI FL
33125-4447
US

IV. Provider business mailing address

525 NW 25TH CT
MIAMI FL
33125-4447
US

V. Phone/Fax

Practice location:
  • Phone: 786-223-9681
  • Fax:
Mailing address:
  • Phone: 786-223-9681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11001268
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: