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General NPI Number Information
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NPI Number | 1437754975
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Entity Type | Individual
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Provider Name | LOREN ELIZABETH PERES
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Gender | Female
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 2001 KINGSLEY AVE
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City | ORANGE PARK
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State | FL
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Zip | 32073-5156
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Country | US
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Telephone | 904-639-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 235 COCONUT PALM PKWY
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City | PONTE VEDRA
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State | FL
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Zip | 32081-6076
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Country | US
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Telephone | 904-612-6466
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN11011082
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License Number State | FL
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