MEDICARE: LARISA PEREZ ISASI 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	104100000X	Social Worker
2	363LF0000X	Family Nurse Practitioner	9358714	FL
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN9358714	FL

General Provider Information

NPI Number	:	1740625821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARISA PEREZ ISASI APRN

Provider Business Mailing Address
First Line	:	3180 SW 118TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-2338
Country	:	US
Telephone Number	:	786-970-4029
Fax Number	:

Provider Business Practice Location Address
First Line	:	3180 SW 118TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-2338
Country	:	US
Telephone Number	:	786-970-4029
Fax Number	:

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

Provider Enumeration Date	:	05/03/2013
Last Update Date	:	06/02/2026

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