Provider Demographics
NPI:1215588108
Name:PEREZ, YANET (APRN)
Entity Type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:YANET
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:9380 SUNSET DR STE B245
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5466
Mailing Address - Country:US
Mailing Address - Phone:305-223-0570
Mailing Address - Fax:305-223-0580
Practice Address - Street 1:9380 SUNSET DR STE B245
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5466
Practice Address - Country:US
Practice Address - Phone:305-223-0570
Practice Address - Fax:305-223-0580
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ003780363LF0000X
FL10327363LF0000X
IDCNP64170363LF0000X
GATEMPARN0028363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP360OtherDL