Provider Demographics
NPI:1912513292
Name:PEREZ, AUNDREA CARMEN JUDITH (DPT)
Entity Type:Individual
Prefix:
First Name:AUNDREA
Middle Name:CARMEN JUDITH
Last Name:PEREZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 E DESERT INN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3632
Mailing Address - Country:US
Mailing Address - Phone:702-294-7499
Mailing Address - Fax:702-735-0097
Practice Address - Street 1:2800 E DESERT INN RD STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3632
Practice Address - Country:US
Practice Address - Phone:702-294-7499
Practice Address - Fax:702-735-0097
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4399225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist