Provider Demographics
NPI:1770930448
Name:PEREZ ALVAREZ, YANET
Entity type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:PEREZ ALVAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4906 SW 137TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-5136
Mailing Address - Country:US
Mailing Address - Phone:786-803-6168
Mailing Address - Fax:
Practice Address - Street 1:11890 SW 8TH ST
Practice Address - Street 2:SUITE 309
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1743
Practice Address - Country:US
Practice Address - Phone:305-220-6060
Practice Address - Fax:888-247-5059
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
106S00000X, 247200000X
FL11018601363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other