Provider Demographics
NPI:1770026924
Name:PERDOMO, FRANCISCA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:FRANCISCA
Middle Name:
Last Name:PERDOMO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:FRANCISCA
Other - Middle Name:
Other - Last Name:PERDOMO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:17820 SE 109TH AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491
Mailing Address - Country:US
Mailing Address - Phone:352-693-2340
Mailing Address - Fax:352-693-2345
Practice Address - Street 1:17820 SE 109TH AVE STE 108
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491
Practice Address - Country:US
Practice Address - Phone:352-693-2340
Practice Address - Fax:352-693-2345
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9214234363LP2300X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care