MEDICARE: EVELYN S PEREZ FNP-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	363LF0000X	Family Nurse Practitioner	ARNP9427530	FL
2	363L00000X	Nurse Practitioner	4704204510	MI

General Provider Information

NPI Number	:	1972872679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVELYN S PEREZ FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1333 3RD AVE S STE 506
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-6538
Country	:	US
Telephone Number	:	239-304-8040
Fax Number	:

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

Provider Enumeration Date	:	12/26/2011
Last Update Date	:	01/26/2026

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