Provider Demographics
NPI:1609589951
Name:FLORIDA APRN QUALITY CONNECT CORPORATION
Entity Type:Organization
Organization Name:FLORIDA APRN QUALITY CONNECT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:TEODULO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN/FAMILY
Authorized Official - Phone:786-470-4563
Mailing Address - Street 1:15900 SW 197TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-1108
Mailing Address - Country:US
Mailing Address - Phone:786-470-4563
Mailing Address - Fax:305-964-5385
Practice Address - Street 1:15900 SW 197TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-1108
Practice Address - Country:US
Practice Address - Phone:786-470-4563
Practice Address - Fax:305-964-5385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty