Healthcare Provider Details

I. General information

NPI: 1104644954
Provider Name (Legal Business Name): PATRICIA PEREZ GUERRA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1562 SW 137TH CT
MIAMI FL
33184-2723
US

IV. Provider business mailing address

5030 BRUNSON DR
CORAL GABLES FL
33146-2412
US

V. Phone/Fax

Practice location:
  • Phone: 786-252-4449
  • Fax: 786-384-8755
Mailing address:
  • Phone: 786-252-4449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11035625
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9540840
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP035547
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN10038335
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11035625
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: