Provider Demographics
NPI:1154868735
Name:PEREZ ZALDIVAR, LESYANI (APRN)
Entity type:Individual
Prefix:
First Name:LESYANI
Middle Name:
Last Name:PEREZ ZALDIVAR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LESYANI
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:306 LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-3103
Mailing Address - Country:US
Mailing Address - Phone:305-531-7311
Mailing Address - Fax:
Practice Address - Street 1:306 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-3103
Practice Address - Country:US
Practice Address - Phone:305-382-4161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-20
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9353363363LF0000X
FLAPRN9343363363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021003600Medicaid