Provider Demographics
NPI:1942081765
Name:PEREZ ALMEIDA, JUAN RAFAEL
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:RAFAEL
Last Name:PEREZ ALMEIDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10311 SW 168TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-4251
Mailing Address - Country:US
Mailing Address - Phone:305-877-7257
Mailing Address - Fax:
Practice Address - Street 1:10311 SW 168TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-4251
Practice Address - Country:US
Practice Address - Phone:305-877-7257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11024708363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner