Provider Demographics
NPI:1649909805
Name:PERNIA, BEATRIX KISS (ARNP)
Entity type:Individual
Prefix:
First Name:BEATRIX
Middle Name:KISS
Last Name:PERNIA
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 1:425 S. HUNT CLUB BLVD. SUITE 2001
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4947
Mailing Address - Country:US
Mailing Address - Phone:407-705-3636
Mailing Address - Fax:407-809-5222
Practice Address - Street 1:425 S. HUNT CLUB BLVD. SUITE 2001
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4947
Practice Address - Country:US
Practice Address - Phone:407-705-3636
Practice Address - Fax:407-809-5222
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-05
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11019792363LF0000X
FLAPRN11019792364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily