=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619337508
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VANESSA PEREZ
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2016
-----------------------------------------------------
Last Update Date | 12/22/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1951 NW 7TH AVE STE 480
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33136-1121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-243-9289
-----------------------------------------------------
Fax | 305-243-8907
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1951 NW 7TH AVE STE 480
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33136-1121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-243-9289
-----------------------------------------------------
Fax | 305-243-8907
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | ARNP9279704
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------