Provider Demographics
NPI:1194204958
Name:ULLOA PEREZ, NAIDY (ARNP)
Entity Type:Individual
Prefix:
First Name:NAIDY
Middle Name:
Last Name:ULLOA PEREZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8951 SW 208TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3885
Mailing Address - Country:US
Mailing Address - Phone:786-683-5591
Mailing Address - Fax:
Practice Address - Street 1:8951 SW 208TH TER
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-3885
Practice Address - Country:US
Practice Address - Phone:786-683-5591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-11
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9406689363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily