Provider Demographics
NPI:1356060248
Name:PERAZA MOREJON, JULIO (APRN)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:
Last Name:PERAZA MOREJON
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 1:12139 S APOPKA VINELAND RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-6802
Mailing Address - Country:US
Mailing Address - Phone:407-730-9911
Mailing Address - Fax:407-778-1479
Practice Address - Street 1:12139 S APOPKA VINELAND RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-6802
Practice Address - Country:US
Practice Address - Phone:407-730-9911
Practice Address - Fax:407-778-1479
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11021355363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily