Provider Demographics
NPI:1194451401
Name:PEREZ, YISSEL (RN)
Entity type:Individual
Prefix:
First Name:YISSEL
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12321 SW 39TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3030
Mailing Address - Country:US
Mailing Address - Phone:305-209-0001
Mailing Address - Fax:786-600-3505
Practice Address - Street 1:10560 NW 27TH ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-5928
Practice Address - Country:US
Practice Address - Phone:305-209-0001
Practice Address - Fax:786-600-3505
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9420538163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse