Healthcare Provider Details

I. General information

NPI: 1992228878
Provider Name (Legal Business Name): MS. RONICE PERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2017
Last Update Date: 07/07/2020
Certification Date: 07/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2668 ROBERT TRENT JONES DR
ORLANDO FL
32835-6272
US

IV. Provider business mailing address

2668 ROBERT TRENT JONES DR
ORLANDO FL
32835-6272
US

V. Phone/Fax

Practice location:
  • Phone: 321-297-2656
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: