Provider Demographics
NPI:1215748702
Name:PEREZ-TEEL, ROSALEE (RN)
Entity type:Individual
Prefix:
First Name:ROSALEE
Middle Name:
Last Name:PEREZ-TEEL
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:PO BOX 758
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:FL
Mailing Address - Zip Code:32147-0758
Mailing Address - Country:US
Mailing Address - Phone:386-546-3190
Mailing Address - Fax:
Practice Address - Street 1:108 BLACKJACK CIR
Practice Address - Street 2:758
Practice Address - City:HOLLISTER
Practice Address - State:FL
Practice Address - Zip Code:32147-0758
Practice Address - Country:US
Practice Address - Phone:386-546-3190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9561959163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse