Provider Demographics
NPI:1235528845
Name:PEREZ, AYOLIA
Entity Type:Individual
Prefix:
First Name:AYOLIA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 E 50TH ST APT 8
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1561
Mailing Address - Country:US
Mailing Address - Phone:786-523-8778
Mailing Address - Fax:
Practice Address - Street 1:380 E 50TH ST APT 8
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1561
Practice Address - Country:US
Practice Address - Phone:786-523-8778
Practice Address - Fax:786-464-0022
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL47-1901474OtherIIRS
FL47-1901474OtherIIRS