Healthcare Provider Details

I. General information

NPI: 1992645147
Provider Name (Legal Business Name): ANDREA PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 SE OCEAN BLVD STE 100
STUART FL
34996-3341
US

IV. Provider business mailing address

928 SE 5TH ST
STUART FL
34994-2466
US

V. Phone/Fax

Practice location:
  • Phone: 772-283-4428
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11045605
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: