Healthcare Provider Details

I. General information

NPI: 1568306686
Provider Name (Legal Business Name): RUDY DANIEL PEREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6025 SORENSEN PKWY
OMAHA NE
68152-2238
US

IV. Provider business mailing address

4501 BIRCH HOLLOW DR
LINCOLN NE
68516-5106
US

V. Phone/Fax

Practice location:
  • Phone: 402-513-0999
  • Fax: 402-513-0999
Mailing address:
  • Phone: 402-513-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: