Healthcare Provider Details

I. General information

NPI: 1770963506
Provider Name (Legal Business Name): JESSICA PEREZ-CARDWELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2015
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 SORRENTO DR STE 7
OSPREY FL
34229-9610
US

IV. Provider business mailing address

8 SORRENTO DR STE 7
OSPREY FL
34229-9610
US

V. Phone/Fax

Practice location:
  • Phone: 941-422-5696
  • Fax: 941-208-9386
Mailing address:
  • Phone: 941-422-5696
  • Fax: 941-208-9386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME146123
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: