Healthcare Provider Details

I. General information

NPI: 1043990591
Provider Name (Legal Business Name): KIRA A TEJADA PEREZ MSN,APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIRA TEJADA APRN

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12955 BISCAYNE BLVD STE 200
NORTH MIAMI FL
33181-2021
US

IV. Provider business mailing address

12955 BISCAYNE BLVD STE 200
NORTH MIAMI FL
33181-2021
US

V. Phone/Fax

Practice location:
  • Phone: 786-245-3035
  • Fax:
Mailing address:
  • Phone: 786-245-3035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11027616
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11027616
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11027616
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: