Provider Demographics
NPI:1841708237
Name:PEREZ PUENTE, MABEL A (ARNP/FNP-C)
Entity type:Individual
Prefix:
First Name:MABEL
Middle Name:A
Last Name:PEREZ PUENTE
Suffix:
Gender:F
Credentials:ARNP/FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8321 NW 7 TH ST BUILDING 1 APT 114
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126
Mailing Address - Country:US
Mailing Address - Phone:786-448-8808
Mailing Address - Fax:
Practice Address - Street 1:8321 NW 7TH ST BUILDING 1 APT 114
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3916
Practice Address - Country:US
Practice Address - Phone:786-448-8808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9283667363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily