MEDICARE: JOSIE 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	363L00000X	Nurse Practitioner	11000538	FL

General Provider Information

NPI Number	:	1164077855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSIE PEREZ APRN

Provider Business Mailing Address
First Line	:	6632 CURRENT DR
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-1538
Country	:	US
Telephone Number	:	204-341-2957
Fax Number	:	813-331-3941

Provider Business Practice Location Address
First Line	:	6128 N US HIGHWAY 41
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-1806
Country	:	US
Telephone Number	:	813-489-9722
Fax Number	:

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

Provider Enumeration Date	:	08/08/2019
Last Update Date	:	02/26/2025

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