Healthcare Provider Details

I. General information

NPI: 1679185441
Provider Name (Legal Business Name): MARGARITA PEREZ MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2020
Last Update Date: 07/15/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 WESTWOOD AVE STE 207
LAKEWOOD OH
44107-3716
US

IV. Provider business mailing address

1406 WESTWOOD AVE STE 207
LAKEWOOD OH
44107-3716
US

V. Phone/Fax

Practice location:
  • Phone: 216-925-4228
  • Fax: 216-208-1412
Mailing address:
  • Phone: 216-925-4228
  • Fax: 216-208-1412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number414658
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number414658
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0033441
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: