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General NPI Number Information
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NPI Number | 1194317164
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Entity Type | Individual
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Provider Name | SELIDETH AMARILYS PEREZ-RIVERO LM, CMP
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Gender | Female
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Dates
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Enumeration Date | 02/10/2021
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 751 19TH ST
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City | SAINT CLOUD
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State | FL
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Zip | 34769-5310
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Country | US
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Telephone | 787-360-9571
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Fax |
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Provider Business Mailing Address
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Address Line | 1533 ELMWOOD AVE
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City | KISSIMMEE
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State | FL
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Zip | 34744-4010
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Country | US
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Telephone | 787-360-9571
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Fax | 407-942-2044
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | MW399
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License Number State | FL
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