Provider Demographics
NPI:1316323967
Name:PEREZ, AILEEN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:AILEEN
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14134 SW 120TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6064
Mailing Address - Country:US
Mailing Address - Phone:305-720-5219
Mailing Address - Fax:
Practice Address - Street 1:14134 SW 120TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6064
Practice Address - Country:US
Practice Address - Phone:305-720-5219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9297981163W00000X
FLARNP9297981363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse