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General NPI Number Information
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NPI Number | 1770963506
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Entity Type | Individual
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Provider Name | JESSICA PEREZ-CARDWELL MD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2015
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 997 US HIGHWAY 41 BYP N STE 201
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City | VENICE
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State | FL
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Zip | 34285-6046
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Country | US
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Telephone | 941-261-4220
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Fax | 941-261-4222
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Provider Business Mailing Address
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Address Line | PO BOX 947407
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City | ATLANTA
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State | GA
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Zip | 30394-7407
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Country | US
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Telephone | 941-917-2600
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Fax | 941-917-7884
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME146123
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License Number State | FL
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