MEDICARE: MARGARITA PEREZ MSN, APRN, PMHNP-BC

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	163WH0200X	Home Health Registered Nurse	414658	OH
2	163WP0808X	Psychiatric/Mental Health Registered Nurse	414658	OH
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0033441	OH

General Provider Information

NPI Number	:	1679185441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARITA PEREZ MSN, APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	1406 WESTWOOD AVE STE 207
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-3716
Country	:	US
Telephone Number	:	216-925-4228
Fax Number	:	216-208-1412

Provider Business Practice Location Address
First Line	:	1406 WESTWOOD AVE STE 207
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-3716
Country	:	US
Telephone Number	:	216-925-4228
Fax Number	:	216-208-1412

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

Provider Enumeration Date	:	08/21/2020
Last Update Date	:	07/15/2024

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