Provider Demographics
NPI:1275208878
Name:PEREZ, NOELLE MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:MARIE
Last Name: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 1:347 NW 48TH AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-9349
Mailing Address - Country:US
Mailing Address - Phone:561-926-4186
Mailing Address - Fax:
Practice Address - Street 1:9980 CENTRAL PARK BLVD N STE 322
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1704
Practice Address - Country:US
Practice Address - Phone:561-488-2988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014847363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily