Provider Demographics
NPI:1083459606
Name:PEREZ, ANNALISE (PT, DPT, NCS)
Entity type:Individual
Prefix:DR
First Name:ANNALISE
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 DERBYSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-3602
Mailing Address - Country:US
Mailing Address - Phone:786-546-3609
Mailing Address - Fax:
Practice Address - Street 1:1300 HEMPEL AVE
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4668
Practice Address - Country:US
Practice Address - Phone:407-407-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT306162251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology