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General NPI Number Information
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NPI Number | 1811211683
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Entity Type | Individual
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Provider Name | JUAN CARLOS PEREZ MA
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Gender | Male
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Dates
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Enumeration Date | 03/22/2010
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 5881 NW 151ST ST # 220
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2497
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Country | US
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Telephone | 786-631-3738
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Fax | 305-675-2861
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Provider Business Mailing Address
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Address Line | 6916 NW 72ND AVE
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City | MIAMI
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State | FL
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Zip | 33166-3036
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Country | US
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Telephone | 305-889-0188
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN9292617
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | HHC 8276
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA33029
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License Number State | FL
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