MEDICARE: MRS. ALICIA PEREZ

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	APRN11021121	FL

General Provider Information

NPI Number	:	1609595982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALICIA PEREZ

Provider Business Mailing Address
First Line	:	15629 NW 38TH CT
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33054-6712
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15629 NW 38TH CT
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33054-6712
Country	:	US
Telephone Number	:	786-973-9517
Fax Number	:

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

Provider Enumeration Date	:	08/22/2022
Last Update Date	:	08/22/2022

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Directions to “ MRS. ALICIA PEREZ ” Practice Location

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