Provider Demographics
NPI:1902374762
Name:PEREZ, MARIEN (APRN)
Entity Type:Individual
Prefix:
First Name:MARIEN
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 SUNSET DR STE 354
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3020
Mailing Address - Country:US
Mailing Address - Phone:305-714-2923
Mailing Address - Fax:058-517-5153
Practice Address - Street 1:10300 SUNSET DR STE 354
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3020
Practice Address - Country:US
Practice Address - Phone:786-374-7521
Practice Address - Fax:305-851-7515
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11000079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily