=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225848666
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARLEET HERNANDEZ PEREZ RT(R)
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2025
-----------------------------------------------------
Last Update Date | 01/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14337 SW 172ND LN
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33177-2739
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-925-0726
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14337 SW 172ND LN
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33177-2739
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-925-0726
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2471C3402X
-----------------------------------------------------
Taxonomy Name | Radiography Radiologic Technologist
-----------------------------------------------------
License Number | CRT106573
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------