Provider Demographics
NPI:1508446030
Name:COLINA PEREZ, JANY (RN, MSN)
Entity Type:Individual
Prefix:
First Name:JANY
Middle Name:
Last Name:COLINA PEREZ
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9480 NW 41ST ST APT 618
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4960
Mailing Address - Country:US
Mailing Address - Phone:305-600-8044
Mailing Address - Fax:
Practice Address - Street 1:9480 NW 41ST ST APT 618
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4960
Practice Address - Country:US
Practice Address - Phone:305-600-8044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-09
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9473628163W00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1801395322Medicaid