Healthcare Provider Details

I. General information

NPI: 1538098074
Provider Name (Legal Business Name): RAIKO ANTONIO PEREZ HERNANDEZ FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 N FLAGLER DR STE 8900
WEST PALM BEACH FL
33401-3404
US

IV. Provider business mailing address

PO BOX 20800
BELFAST ME
04915-4105
US

V. Phone/Fax

Practice location:
  • Phone: 561-833-0770
  • Fax: 561-659-4830
Mailing address:
  • Phone: 469-803-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11047631
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: