Healthcare Provider Details

I. General information

NPI: 1427533868
Provider Name (Legal Business Name): ERICK BENJAMIN PEREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15680 SW 88TH ST STE 201
MIAMI FL
33196-1160
US

IV. Provider business mailing address

17626 SW 10TH ST
PEMBROKE PINES FL
33029-4845
US

V. Phone/Fax

Practice location:
  • Phone: 305-338-9828
  • Fax: 786-691-4268
Mailing address:
  • Phone: 305-338-9828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9351933
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9351933
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: