MEDICARE: AIDA M PEREZ SANTAMARIA MSN, APRN, NP-C

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	163WC0400X	Case Management Registered Nurse	RN9285606	FL
2	363LF0000X	Family Nurse Practitioner	APRN9285606	FL

General Provider Information

NPI Number	:	1730672650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIDA M PEREZ SANTAMARIA MSN, APRN, NP-C

Provider Business Mailing Address
First Line	:	1748 W 56TH TER UNIT 410
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2006
Country	:	US
Telephone Number	:	786-319-8826
Fax Number	:

Provider Business Practice Location Address
First Line	:	1748 W 56TH TER UNIT 410
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2006
Country	:	US
Telephone Number	:	786-319-8826
Fax Number	:

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

Provider Enumeration Date	:	06/14/2018
Last Update Date	:	03/05/2021

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