Healthcare Provider Details

I. General information

NPI: 1710702188
Provider Name (Legal Business Name): ALEXEY HERNANDEZ PEREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 WESTON RD STE 101B
WESTON FL
33326-1112
US

IV. Provider business mailing address

16531 BLATT BLVD APT 105
WESTON FL
33326-1828
US

V. Phone/Fax

Practice location:
  • Phone: 954-659-1208
  • Fax:
Mailing address:
  • Phone: 239-922-3935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9671708
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: