Provider Demographics
NPI:1255191136
Name:PEREZ CEBALLO, ARLENY (ARNP)
Entity type:Individual
Prefix:
First Name:ARLENY
Middle Name:
Last Name:PEREZ CEBALLO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5308
Mailing Address - Country:US
Mailing Address - Phone:786-614-9463
Mailing Address - Fax:
Practice Address - Street 1:7300 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5308
Practice Address - Country:US
Practice Address - Phone:786-614-9463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11031892363LF0000X
FLAPRN11031892363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care