MEDICARE: RAQUEL PEREZ FNP

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	ARNP9434464	FL
2	363LF0000X	Family Nurse Practitioner	APRN9434464	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790223386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAQUEL PEREZ FNP

Provider Business Mailing Address
First Line	:	10503 SAN JOSE BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-6295
Country	:	US
Telephone Number	:	904-450-6670
Fax Number	:	904-450-6699

Provider Business Practice Location Address
First Line	:	10503 SAN JOSE BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-6295
Country	:	US
Telephone Number	:	904-450-6670
Fax Number	:	904-450-6699

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

Provider Enumeration Date	:	02/03/2017
Last Update Date	:	12/02/2025

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