Healthcare Provider Details

I. General information

NPI: 1609589951
Provider Name (Legal Business Name): FLORIDA APRN QUALITY CONNECT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11983 TAMIAMI TRL N STE 102
NAPLES FL
34110-1600
US

IV. Provider business mailing address

15900 SW 197TH AVE
MIAMI FL
33187-1108
US

V. Phone/Fax

Practice location:
  • Phone: 786-470-4563
  • Fax: 305-964-5385
Mailing address:
  • Phone: 786-470-4563
  • Fax: 305-964-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TEODULO JOSE PEREZ
Title or Position: APRN
Credential: APRN/FAMILY
Phone: 786-470-4563