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General NPI Number Information
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NPI Number | 1043817232
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Entity Type | Individual
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Provider Name | TEODULO JOSE PEREZ
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Gender | Male
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 9035 SUNSET DR STE 202
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City | MIAMI
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State | FL
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Zip | 33173-3451
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Country | US
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Telephone | 305-279-3366
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Fax | 305-271-3355
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Provider Business Mailing Address
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Address Line | 2699 STIRLING RD STE B100
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City | FT LAUDERDALE
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State | FL
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Zip | 33312-6543
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Country | US
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Telephone | 305-223-8808
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11009441
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License Number State | FL
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