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General NPI Number Information
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NPI Number | 1629844857
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Entity Type | Individual
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Provider Name | JUANIEL E PEREZ DC
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Gender | Male
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Dates
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Enumeration Date | 11/29/2023
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1967 SE PORT ST LUCIE BLVD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952-5536
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Country | US
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Telephone | 772-335-3110
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Fax |
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Provider Business Mailing Address
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Address Line | 742 SE STARFLOWER AVE
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-4637
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Country | US
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Telephone | 787-632-6370
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 14759
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License Number State | FL
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