Healthcare Provider Details

I. General information

NPI: 1992457733
Provider Name (Legal Business Name): KIRSIS PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5664 SW 60TH AVE
OCALA FL
34474-5677
US

IV. Provider business mailing address

5664 SW 60TH AVE
OCALA FL
34474-5682
US

V. Phone/Fax

Practice location:
  • Phone: 352-291-5500
  • Fax:
Mailing address:
  • Phone: 352-565-7518
  • Fax: 352-565-7518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11017345
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11017345
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11017345
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: