Provider Demographics
NPI:1801371612
Name:PEREZ LUIS, NELYS (NP)
Entity Type:Individual
Prefix:MRS
First Name:NELYS
Middle Name:
Last Name:PEREZ LUIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12941 SW 251ST TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5788
Mailing Address - Country:US
Mailing Address - Phone:305-904-3844
Mailing Address - Fax:
Practice Address - Street 1:12941 SW 251ST TER
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-5788
Practice Address - Country:US
Practice Address - Phone:305-904-3844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9371733363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily