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General NPI Number Information
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NPI Number | 1801303540
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Entity Type | Individual
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Provider Name | LEE TASHA PEREZ LMT, DOM, AP
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Gender | Female
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Dates
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Enumeration Date | 01/03/2018
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 8840 TERRENE CT STE 101
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City | BONITA SPRINGS
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State | FL
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Zip | 34135
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Country | US
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Telephone | 239-246-6622
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Fax | 239-344-8732
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Provider Business Mailing Address
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Address Line | 8840 TERRENE CT STE 101
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-9533
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Country | US
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Telephone | 239-246-6622
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Fax | 239-344-8732
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP3901
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License Number State | FL
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