Provider Demographics
NPI:1134813488
Name:PEREZ, ANA MILENA (ND)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MILENA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 SW 66TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5510
Mailing Address - Country:US
Mailing Address - Phone:786-670-0595
Mailing Address - Fax:
Practice Address - Street 1:1431 SW 66TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5510
Practice Address - Country:US
Practice Address - Phone:786-670-0595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6386133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist