MEDICARE: JUMIRLET ORTEGA PEREZ APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	11029443	FL

General Provider Information

NPI Number	:	1053184341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUMIRLET ORTEGA PEREZ APRN

Provider Business Mailing Address
First Line	:	1211 W 33RD ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4807
Country	:	US
Telephone Number	:	786-202-9563
Fax Number	:

Provider Business Practice Location Address
First Line	:	6161 BLUE LAGOON DR STE 170
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-2045
Country	:	US
Telephone Number	:	786-388-1400
Fax Number	:	786-388-1219

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2023
Last Update Date	:	10/30/2023

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Directions to “ JUMIRLET ORTEGA PEREZ APRN” Practice Location

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