MEDICARE: EVELYN ROSA 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	101YP1600X	Pastoral Counselor		FL

General Provider Information

NPI Number	:	1710839212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVELYN ROSA PEREZ

Provider Business Mailing Address
First Line	:	1186 PECAN ST
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34744-4965
Country	:	US
Telephone Number	:	407-334-7467
Fax Number	:

Provider Business Practice Location Address
First Line	:	1186 PECAN ST
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34744-4965
Country	:	US
Telephone Number	:	407-334-7467
Fax Number	:

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

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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Directions to “ EVELYN ROSA PEREZ ” Practice Location

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