Provider Demographics
NPI:1992393466
Name:LEAL PEREZ, MONICA (APRN)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:LEAL PEREZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19525 W LAKE DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2246
Mailing Address - Country:US
Mailing Address - Phone:786-499-3723
Mailing Address - Fax:
Practice Address - Street 1:19525 W LAKE DR
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-2246
Practice Address - Country:US
Practice Address - Phone:786-499-3723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-09
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009097363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily