Provider Demographics
NPI:1689238073
Name:PEREZ, GABRIEL ANGEL (APRN, FNP, MSN)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:ANGEL
Last Name:PEREZ
Suffix:
Gender:M
Credentials:APRN, FNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15969 NW 64TH AVE APT 107
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5574
Mailing Address - Country:US
Mailing Address - Phone:786-286-2557
Mailing Address - Fax:
Practice Address - Street 1:15969 NW 64TH AVE APT 107
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-5574
Practice Address - Country:US
Practice Address - Phone:786-286-2557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000727363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily