Provider Demographics
NPI:1023568748
Name:PEREZ, MICHELLE ANNETTE (MSN, ARNP, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ANNETTE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MSN, ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6475 SUGAR TREE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34607-2517
Mailing Address - Country:US
Mailing Address - Phone:352-573-7640
Mailing Address - Fax:
Practice Address - Street 1:6475 SUGAR TREE DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34607-2517
Practice Address - Country:US
Practice Address - Phone:352-573-7640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9234512363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily